Caregiver Burden Research Articles

Factors Associated with Increased Burden of Caregivers of People with Dementia with Lewy Bodies.

The burden of caregivers of people with dementia with Lewy bodies (DLB) is high; however, factors related to their caregiving burden are not fully clarified. We herein investigated factors associated with increasing caregiver burden for caregivers of people with DLB. To explore factors associated with caregiver burden, a linear regression analysis was conducted using the J-ZBI_8 total score as the dependent variable and a total of 36 factors as independent variables. This analysis included 252 pairs of people with DLB and their caregivers. Caregivers' mean J-ZBI_8 was 8.4, indicating that caregiver burden was generally high. First, we identified 20 factors associated with caregiver burden in univariable analysis. Finally, multivariable analysis found three significant factors: irritability (β = 0.208, p < 0.001), use of "short stay" or "small-scale, multifunctional home care" (β = 0.208, p < 0.001), and nighttime behavior (β = 0.138, p = 0.020) were significantly associated with J-ZBI_8 total scores. Irritability and nighttime behavior were found to be contributing factors to caregiver burden. High caregiver burden among caregivers of people with DLB may result in the use of social services providing overnight stays, but to what extent such services reduce caregiver burden is unknown.

"Everyone blames you": Stigma and caregiver burden among parents of children with substance use disorder.

Recent increases in drug overdose deaths have created a significant public health crisis in the United States. Individuals diagnosed with substance use disorder (SUD) often rely on their social support network as they engage in treatment and recovery. While support from parents, in particular, can be vital in recovery, stress associated with supporting loved ones with SUD can have detrimental effects on health and well-being. Stigma toward parents and loved ones further complicates the support they can offer. The present study explores caregiver burden and stigma experienced by parents of children with SUD. The impact of these experiences on their ability to access support and resources, both for themselves and their children, is of particular interest. In-depth one-on-one interviews were conducted with 25 parents (92% mothers) of children (ages 17-32 years old) with SUD. Qualitative thematic analysis resulted in three themes: (1) caregiving and associated burden, (2) parent experiences with SUD stigma, and (3) impact of stigma on caregiver support. Experiences of burden and stigma were prevalent; parents reported stigma directed at them due to their child's diagnosis (associative stigma) as well as psychological distress they experienced witnessing their children experience stigma (vicarious stigma). Fear of judgment and shame led parents to avoid disclosing their child's SUD to others and impeded help-seeking behavior. When parents did seek formal help, resources were limited and insufficient. The findings underscore the need for increased understanding and acceptance from the community, emphasizing the potential role of education in reshaping perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of Psychoeducation on Caregivers of Individuals Experiencing Schizophrenia: A Systematic Review and Meta-Analysis.

The existing paradigm on recovery in mental health prioritises self-empowerment and person-centred, community-based care, which necessitates family caregivers' collaboration to support individuals with schizophrenia in the community. However, the role of family caregivers is often under-recognised and hence insufficiently supported. This consequently compromises caregivers' well-being and, ultimately, the recovery of individuals with schizophrenia. Although caregiver-targeted psychoeducation may offer practical support, its effectiveness lacks conclusive evidence. This review aimed to evaluate the impacts of psychoeducation on caregiver-related outcomes (caregiver burden, quality of life and expressed emotion). Eight electronic databases were searched from inception to September 2023, supplemented by hand searching of end-reference lists. Two reviewers independently conducted title and abstract screening with predetermined eligibility criteria. A third reviewer was consulted to resolve any discrepancies. A random-effects meta-analysis was performed to estimate pooled effect sizes alongside subgroup and sensitivity analyses where appropriate. Twenty-one studies (totalling 1639 caregivers) were included, based on which psychoeducation contributed to a statistically significant improvement in caregiver-related outcomes. Given substantial heterogeneity, subgroup and sensitivity analyses were done for the durations and the evaluative scales for psychoeducation. Quality appraisal revealed unclear or high bias in most studies. Notwithstanding the heterogeneity, the directions of the effect sizes consistently indicated the effectiveness of psychoeducation across all outcomes. This finding aligned with Lazarus' stress appraisal and coping theory, which states that psychoeducation improves caregivers' knowledge, coping mechanisms and situation appraisal. Our findings offer encouraging evidence to advocate the integration of psychoeducation into healthcare services, but policy-based support is warranted for sustained implementation. Further research is merited to optimise its duration and content and appraise its long-term impacts through disease-specific scales for objective and subjective outcomes.

Behavioral Management in the Rehabilitation of a Person with Severe Mental Illness: The Path Less Travelled

In severe mental illness (SMI), such as schizophrenia, rehabilitation begins immediately. Aside from the token economy, there is limited literature on behavioral modification (BM), which is a crucial aspect of rehabilitation for person with severe mental illness (SMI). We demonstrate the implementation and effectiveness of BM for one year in managing behavioral difficulties in a person with SMI. The direct observation method and the ABC functional analysis model were used for evaluation. Management, such as reinforcement and punishment, was implemented. Pre- and postassessments revealed a considerable decrease in problematic behaviors. This article also highlights the obstacles faced while managing the case and caregiver burden in rehabilitation. In persons with SMI, the application of BM enhances the patient’s functionality and reduces the caregiver burden.

Case management for people with acquired brain injury: feasibility and effectiveness of a two-year pragmatic randomized controlled trial

ABSTRACT Background Case management (CM) aims to facilitate access to and integration of health care and social services. We investigated the feasibility and effectiveness of CM. Methods Randomized controlled trial with 219 patients and 114 caregivers randomly allocated to CM (109/59) or care as usual (110/55). CM was based on early and continuous online monitoring of problems and needs. Outcomes were assessed every 6 months with the Hospital Anxiety and Depression Scale (HADS). Secondary outcome domains were participant restrictions, life satisfaction, self-efficacy, caregiver burden, and needs. Multilevel modeling was used. Feasibility aspects were protocol delivery, participants’ and case managers’ satisfaction, and factors affecting implementation. Results There were no significant differences between groups. Participation restrictions and unmet needs decreased in both groups within 6 months. Monitoring was successful in 38, and 10 participants asked the CM for support. CM consisted mostly of providing information. Discussion CM based on early and continuous online monitoring does not have benefit in identifying and addressing problems early after relatively mild injury. Unsuccessful monitoring may have hindered access to the case manager and prevented us from evaluating CM as a complex intervention. It remains a challenge to early identify those who could benefit from care coordination.

Impact of hemispherotomy on quality of life and burden of caregivers in children and adolescents: a retrospective observational study.

To evaluate QOL and caregiver burden of children and teenagers submitted to hemispherotomy for pharmacoresistant epilepsy, by comparing pre and post-surgical intervention data. Retrospective analysis of pediatric patients submitted to surgical hemispherotomy before intervention (preOP) and their follow-up at 6months (6M PO) and 2years (2Y PO) after surgery. QOL was evaluated through the Quality of Life in Childhood Epilepsy (QVCE-50) questionnaire and caregiver burden, through the Zarit Burden Interview (ZBI) tool. Twenty-two patients were included in the study. Sixteen patients (72%) were classified as Engel I at 2Y PO follow-up. QVCE-50 scale showed improvement of total QOL at 2Y PO. In relation to QVCE-50-specific domains, there was an improvement in the physical domain and in the cognitive-education a decrease in psychological and a stabilization in social/familiar domain scores. The majority of caregivers classified their burden as mild to moderate, with no PO improvement. Hemispherotomy represents an effective seizure control treatment, as well as it contributes to improvement of QOL, particularly in the physical domain and in spite of children's physical and cognitive limitations. However, no improvement in caregiver burden was observed, probably due to the chronic condition of these patients, which might be worsened by social issues.

Community-based elderly home care services policy and household consumption enhancement: Evidence from China

The influence of elderly consumption is increasing, and community-based elderly home care service (CEHCS), as an important social security system, will have a significant impact on household consumption levels and consumption structure. This paper utilizes data from five batches of CEHCS pilot policies implemented in China from 2016 to 2020, combined with data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, to design a dynamic difference-in-differences model to systematically evaluate the dynamic effects and mechanisms of CEHCS on elderly household non-durable goods consumption. The study found that after the coverage of CEHCS, the consumption levels of non-durable goods such as clothing, daily necessities, and cultural and entertainment products in middle-aged and elderly households significantly increased year by year, while consumption of durable goods significantly decreased. Moreover, the impact of CEHCS was more pronounced in households with lower housing assets and rural households. Mechanism analysis suggests that CEHCS promote the increase in non-durable goods consumption by alleviating children's labor constraints, reducing the family's caregiving burden, and diminishing precautionary savings. This paper provides further empirical evidence on the pathways through which elderly care services influence household consumption behavior, which holds significant implications for proactively addressing population aging and unlocking household consumption potential through micro-institutional design.

Informal Caregiver Burden and Potential Consequences

Providing care to an adult loved one is often described as a burden, but it can also promote flourishing. The present study examined the extent to which state hope and emotion regulation strategies of positive reappraisal and emotional suppression might account for the relation of burden on both burnout and flourishing in a sample of 162 informal caregivers (54.8% women; Mage = 42.92, SDage = 13.22). It was hypothesized that state hope would mediate the relationship between caregiver burden and both outcomes, with state hope being positively related to flourishing and negatively related to burnout. It was also hypothesized that positive reappraisal and emotional suppression would mediate the relationship between caregivers’ burden and the outcomes, with positive reappraisal predicting greater flourishing and emotional suppression predicting greater burnout, as well as less flourishing. Participants were recruited from the Prolific crowd sourcing platform and had been pre-screened as informal and unpaid caregivers of an adult. They completed a battery of questionnaires that were all self-report in nature for the cross-sectional design. Results indicate that only state hope mediated the relationship between caregiver burden and the outcomes of burnout and flourishing. Contrary to what was hypothesized, emotion regulation strategy was not a mechanism in these relationships. State hope could be a potential avenue for intervention for informal caregivers in that it may impact caregiver burden as well as burnout and flourishing.

Health-related quality of life and caregiver burden of pediatric patients with inborn errors of metabolism in Japan using EQ-5D-Y, PedsQL, and J-ZBI.

Inborn errors of metabolism (IEM) are known with poor long-term health concerns; however, the health-related quality of life (HRQoL) and the burden placed on families remain unclear. This study investigated the self- and proxy-reported HRQoL of pediatric patients with IEM with or without developmental disabilities and the burden placed on their caregivers. Patients with IEM aged 8-15years and their caregivers were asked to respond to the Pediatric Quality of Life Inventory (PedsQL), EuroQoL five-dimension questionnaire for younger populations (EQ-5D-Y), and Japanese version of the Zarit Caregiver Burden Interview (J-ZBI). We compared EQ-5D-Y scores with matched EQ-5D-Y population norms. Intraclass correlation coefficients (ICC) for self and proxy HRQoL scores of those without developmental disabilities were calculated. Correlation coefficients of HRQoL proxy responses with J-ZBI score were estimated. We included 66 patients with IEM (mean age, 11.5years; males, 41.2%) in the study. The mean (± standard deviation) EQ-5D-Y scores without and with developmental disabilities were 0.957 (± 0.071) and 0.821 (± 0.175), respectively. The EQ-5D-Y scores significantly increased compared with the reference values (p < 0.01, effect size = 0.337). The ICC values were 0.331 and 0.477 for the EQ-5D-Y and PedsQL scores, respectively. HRQoL proxy scores had strong negative correlations with J-ZBI scores. The HRQoL of patients with IEM without developmental disabilities in our study was similar to that of the general Japanese population. The HRQoL of patients with IEM with developmental disabilities was low and associated with a tendency towards an increased burden of care.

"They forget that I'm a human being"-ward round communication with older patients living with frailty and informal caregivers: a qualitative study.

Skilful communication prompts quality patient care. Informal caregivers occupy a crucial role when caring for hospitalised older patients living with frailty. However, skilful communication with both patients and informal caregivers during ward rounds has not been studied. Thus, we aimed to explore communication preferences of patients and informal caregivers during ward rounds. We conducted semi-structured interviews with hospitalized patients and informal caregivers until information redundancy occurred. We used inductive coding of the transcribed interviews followed by a reflexive thematic analysis. The study included 15 patients and 15 informal caregivers. Patients had a median age of 85years (range 75-100years) and seven patients were females. Informal caregivers' median age were 45years (range 38-80years) and 13 were females. Three themes were generated: (1) building relationships and conveying information, (2) alleviating informal caregiver strain and (3) sharing the decision-making process. Themes highlighted the importance of collaborative and empathetic approaches in healthcare interactions, emphasizing interpersonal communication skills, such as fostering professional relationships. The interviews unveiled informal caregiver burden stemming from disempowerment during hospital discharge process and managing mistrust within the healthcare system. The shared decision-making process should address patients' and informal caregivers' needs and circumstances. Communication preferences of a population of older patients living with frailty and informal caregivers during ward rounds encompass interpersonal communication, demonstrating ample time, and being seen as a human being. Informal caregivers value being included in the decision-making process. Skilful communication includes for doctors to recognize informal caregivers' narratives and burdens.

Care burden and associated factors among caregivers of patients with bipolar type I disorder

BackgroundFamily caregivers play a significant role in providing care for these people at home and need new evidence on the outcomes of their caregiving. Caregiving for people with chronic psychiatric disorders, especially Bipolar type I Disorder (BD-I), is a major challenge in the healthcare system. This study aimed to examine the relationship between caregiver burden, resilience and optimism in family caregivers of patients with BD-I.MethodsThis study used a cross-sectional design and involved 209 family caregivers of people with BD-I by convenience sampling method. Data were collected using the Zarit Burden Inventory (ZBI), Connor-Davidson Resilience Scale (CD-RISC), and Revised Life Orientation Test (LOT-R). The participants were selected from the list of family caregivers covered by the Ibn Sina Hospital’s health clinic in Mashhad, Iran. The data were analyzed using descriptive statistics and multiple regression analysis with a significance level of 0.05.ResultsThe average ages of the caregivers and their patients were 45.43 (13.34) and 36.7 (14.05), respectively. The average caregiver burden score was 41.92 (19.18), which was moderate (31 to 60). The predictors of caregiver burden in this study were caregiver-related factors such as optimism (p < 0.001, β = 0.25) and employment status (housewife: p = 0.038, β = 0.43; self-employed: p = 0.007, β = 0.12; retired: p < 0.001, β = 0.23), and patient-related factors such as the presence of psychotic symptoms (p < 0.001, β = 0.33), daily caregiving hours (p < 0.001, β = 0.16), history of suicide attempts (p = 0.035, β = 0.43), and alcohol consumption (p < 0.001, β = 0.85). These variables explained 58.3% of the variance in caregiver burden scores.ConclusionThe study concluded that family caregivers of people with BD-I had moderate levels of caregiver burden and low resilience, influenced by various factors related to themselves and their patients. Psychological education interventions within the framework of mental health support systems are recommended to reduce caregiver burden in these people.

Experiences of siblings of children with profound intellectual and multiple disabilities: a qualitative systematic review protocol.

The objective of this systematic review is to explore the experiences of siblings of children with profound intellectual and multiple disabilities. With improved life expectancy of children with profound intellectual and multiple disabilities, the research focus is on care at home and in the community. Although parents are the primary caregivers, siblings often assume the role of young caregivers, bearing the weight of caregiving responsibilities. Thus, a synthesis of qualitative findings is required regarding their experiences to facilitate the development of effective support strategies. Siblings of children with profound intellectual and multiple disabilities will be included, defined as children with an IQ of ≤40 or mental development below a 2-year-old's level, coupled with an inability to walk independently. Disabled children aged <20 years will be included. There will be no restrictions on the siblings' age or type of relationship. Qualitative studies on experiences, caregiving burdens, challenges, difficulties, and frustration in daily life will be considered, covering home, community, school, and hospital settings for children with disabilities. We will follow the JBI methodology for systematic reviews of qualitative evidence. The search strategy will be conducted in 3 phases: initial limited search, comprehensive database search, and reference list search of the included articles. The MEDLINE, CINAHL Plus, PsycINFO, Scopus, Ichushi-Web, and CiNii databases will be searched, with no restrictions on language or publication date. Study selection, critical appraisal, data extraction, and data synthesis will be conducted by 2 independent reviewers. We will evaluate the final synthesized findings using the ConQual approach. PROSPERO CRD42024499042.

Mortality and Function After Widowhood Among Older Adults With Dementia, Cancer, or Organ Failure

The widowhood effect, in which mortality increases and function decreases in the period following spousal death, may be heightened in older adults with functional impairment and serious illnesses, such as cancer, dementia, or organ failure, who are highly reliant on others, particularly spouses, for support. Yet there are limited data on widowhood among people with these conditions. To determine the association of widowhood with function and mortality among older adults with dementia, cancer, or organ failure. This longitudinal cohort study used population-based, nationally representative data from the Health and Retirement Study database linked to Medicare claims from 2008 to 2018. Participants were married or partnered community-dwelling adults aged 65 years and older with and without cancer, organ failure, or dementia and functional impairment (function score <9 of 11 points), matched on widowhood event and with follow-up until death or disenrollment. Analyses were conducted from September 2021 to May 2024. Widowhood. Function score (range 0-11 points; 1 point for independence with each activity of daily living [ADL] or instrumental activity of daily living [IADL]; higher score indicates better function) and 1-year mortality. Among 13 824 participants (mean [SD] age, 70.1 [5.5] years; 6416 [46.4%] female; mean [SD] baseline function score, 10.2 [1.6] points; 1-year mortality: 0.4%) included, 5732 experienced widowhood. There were 319 matched pairs of people with dementia, 1738 matched pairs without dementia, 95 matched pairs with cancer, 2637 matched pairs without cancer, 85 matched pairs with organ failure, and 2705 matched pairs without organ failure. Compared with participants without these illnesses, widowhood was associated with a decline in function immediately following widowhood for people with cancer (change, -1.17 [95% CI, -2.10 to -0.23] points) or dementia (change, -1.00 [95% CI, -1.52 to -0.48] points) but not organ failure (change, -0.84 [95% CI, -1.69 to 0.00] points). Widowhood was also associated with increased 1-year mortality among people with cancer (hazard ratio [HR], 1.08 [95% CI, 1.04 to 1.13]) or dementia (HR, 1.14 [95% CI, 1.02 to 1.27]) but not organ failure (HR, 1.02 [95% CI, 0.98 to 1.06]). This cohort study found that widowhood was associated with increased functional decline and increased mortality in older adults with functional impairment and dementia or cancer. These findings suggest that persons with these conditions with high caregiver burden may experience a greater widowhood effect.

Healthcare Professionals' Perspectives on Post-Diagnostic Care for People with Vascular Cognitive Impairment: When Help Is Needed in a "No-Man's Land".

Post-diagnostic care for people with vascular cognitive impairment (VCI) typically involves multiple professions and disjointed care pathways not specifically designed to aid VCI needs. Exploring perspectives of healthcare professionals on post-diagnostic care for people with VCI. We conducted a qualitative focus group study. We used purposive sampling to include healthcare professionals in different compositions of primary and secondary care professionals per focus group. Thematic saturation was reached after seven focus groups. Transcripts were iteratively coded and analyzed using inductive thematic analysis. Forty participants were included in seven focus groups (4-8 participants). Results showed knowledge and awareness of VCI as prerequisites for adequate post-diagnostic care, and for pre-diagnostic detection of people with VCI (theme 1). In light of perceived lack of differentiation between cognitive disorders, participants shared specific advice regarding post-diagnostic care for people with VCI and informal caregivers (theme 2). Participants thought current care for VCI was fragmented and recommended further integration of care and collaboration across settings (theme 3). People with VCI and their caregivers risk getting stuck in a "no man's land" between post-diagnostic care pathways; challenges lie in acknowledgement of VCI and associated symptoms, and alignment between healthcare professionals. Education about the symptoms and consequences of VCI, to healthcare professionals, people with VCI and caregivers, may increase awareness of VCI and thereby better target care. Specific attention for symptoms common in VCI could further tailor care and reduce caregiver burden. Integration could be enhanced by combining expertise of dementia and stroke/rehabilitation pathways.

Burden in caregivers of patients with schizophrenia, depression, dementia, and stroke in Japan: comparative analysis of quality of life, work productivity, and qualitative caregiving burden

BackgroundThe main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer’s disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder.MethodsThe Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder.ResultsCaregivers of patients with schizophrenia, depression, Alzheimer’s disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer’s disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem.ConclusionsThis study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer’s disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients.Trial RegistrationNone.

Association between apathy and caregiver burden in patients with amyotrophic lateral sclerosis: a cross-sectional study

ObjectivesTo investigate the relationship among patients’ apathy, cognitive impairment, depression, anxiety, and caregiver burden in amyotrophic lateral sclerosis (ALS).DesignA cross-sectional study design was used.SettingThe study was conducted at a tertiary...

Predictors of caregiver burden in Alzheimer’s disease: Caregiver stress, life satisfaction and quality of life levels

Objective: The purpose of this study was to determine the impact of socio-demographic and health characteristics, caregiving stress, life satisfaction, and quality of life on the caregiving burden in caregivers of Alzheimer’s patient. Methods: This study is a descriptive-correlational type study. A total of 146 individuals who are caregivers of Alzheimer’s patient constitute the sampling of the study. The Zarit Burden Interview, Caregiver Strain Index, Satisfaction with Life Scale, and SF-36 Quality of Life. Results: The care burden mean score of caregivers was 61.29±10.3. It was determined that age (β=0.648), caring duration (β=0.429), gender(β=0.672), marital status(β=0.936), educational status(β=0.863), the affinity of the caregiver with the patient(β=0.734), working status(β=0.524), perceived income adequacy(β=0.926), perceived health condition(β=0.682), presence of chronic disease(β=0.529), caregiving stress(β=0.633), life satisfaction score(β=-0.775), physical subscale score (β=-0.824) and mental subscale score(β=-0.489) quality of life had an influence on the caregiving burden (p&lt;0.001). It was determined that the effective determining factors account for 76.4% of the variation in the caregiving burden. Conclusions: The caregivers of Alzheimer’s disease patients have a high caring burden. In addition to the socio-demographic and health characteristics of caregivers, caregiving stress, life satisfaction, and quality of life are important determinants of the caring burden.

Translation, cross-cultural adaptation, and validation of the Italian version of the Parkinson's disease caregiver burden questionnaire (PDCB-I).

To translate and cross-culturally adapt the Parkinson's Disease Caregiver Burden questionnaire (PDBC) into Italian language and to evaluate the psychometric properties of the Italian version in terms of test-retest reliability, internal consistency, and construct validity. The PDBC-I was developed by forward-backward translation to establish correspondence with the original English latest version. Psychometric properties were estimated in a sample of primary caregivers of individuals with Parkinson's disease. Reliability testing included internal consistency (Cronbach's alpha), test-retest reliability (ICC), the standard error of measurement (SEM) and the minimal detectable change (MDC), also expressed as percentage (MDC%). Validity was estimated by comparing the PDBC -I to the Caregiver Burden Inventory (CBI) and the Short Form 36 (SF-36) (Pearson correlation coefficient). The questionnaire was administered to 65 caregivers, showing internal consistency of 0.934. ICC value was 0.811 (95% CI 0.708-0.880) for test-retest reliability, and the SEM and the MDC (MDC%) were 5.04 and 13.97 (38.21%), respectively. Low to moderate correlation with all other investigated scales (CBI: r=0.693; SF-36 physical score: r=-0.309; SF-36 mental score: r=-0.588; SF36 total score: -0.470) were found. Despite the PDCB-I holds acceptable psychometric properties to be used in clinical settings of Italian-speaking Countries as a measure of caregiver burden in caregivers of individuals with Parkinson Disease, the caregiver might require the support of a clinician to finalize the compilation of the questionnaire.

Forced oscillation control with a wearable reaction wheel to assist human periodic arm swing

Rehabilitation for stroke patients includes periodic arm exercises, but these require assistance by caregivers at the start of the exercise, which is a burden for caregivers. In this study, we have developed a system with three reaction wheel mechanisms, which can generate not only moments in each direction but also a larger moment than the output of a single axis by interlocking the axes. In addition, by using forced oscillation control, it is possible to assist the movement of the wearer's periodic arm swing even if the weight and output moment of the reaction wheel is not large. Although a large torque of 2.65 Nm is required for the system to swing the arm, it was confirmed that the developed device can be used to increase the amplitude of arm oscillation and achieve an oscillation frequency equivalent to that of a human arm swing, even with a single reaction wheel exerting a torque of 0.4 Nm.

Resilience of Family Caregivers of People With Dementia in South Korea: A Scoping Review.

Due to rapid increases in the number of Korean people with dementia, dementia has become a priority health issue in South Korea. Likewise, the well-being of family caregivers of people with dementia has also become an issue of concern. However, little is known about the resilience of Korean family caregivers because there is a lack of review studies from a Korean cultural perspective about the resilience of family caregivers of people with dementia. The purpose of this scoping review was to investigate quantitative studies related to resilience theories, measurement instruments, correlates and resilience interventions for family caregivers of people with dementia. This review was conducted according to the Joanna Briggs Institute based on Arksey and O'Malley. Nine databases were searched to retrieve evidence published in English or Korean between January 2000 and September 2022. Studies with a quantitative research design reporting the resilience of family caregivers of people with dementia based on a resilience theory framework were included. A total of 13 studies were included in this review. All studies used either a modified McCubbin and McCubbin's family stress, adjustment and adaptation model or Walsh's family resilience model. All resilience instruments were used without cross-cultural adaptation. Family adaptation, social support, life satisfaction, family (di)stress and caregiver burden were associated with resilience among family caregivers. A few family resilience-enhancing programmes showed a positive effect on caregiver resilience. This review noted that all the resilience measures documented in this study need to test for cultural adaptation in a Korean context. Further research is required to develop and implement family-based, culturally tailored interventions to effectively enhance Korean resilience for family caregivers of people with dementia. Gerontological nurses should include Korean family caregivers in their nursing care and assess whether family caregivers have depression or suicidal thoughts to promote better health outcomes for caregivers and their family members.