Caregiver Characteristics Research Articles

Sharing in caring: Family caregiving task sharing patterns for older adults in Singapore.

Research on family caregiving for older adults has largely focused on primary caregivers. We identify caregiving task sharing patterns among multiple caregivers, including family members and live-in hired workers. In addition, we investigate caregiver and care-recipient characteristics associated with these patterns. We interviewed 278 primary family caregivers of home-dwelling older adults in Singapore about who provides what assistance across three domains: activities of daily living, health and social services use, and socio-emotional and other needs. Latent class analysis was used to identify caregiving task sharing patterns. Three patterns were identified: a) 'Shared-Diverse' (39%) - multiple caregivers assisting in all three domains, b) 'Shared-Domestic' (32%) - multiple caregivers assisting with activities of daily living and socio-emotional and other needs, and c) 'Solo-Diverse' (29%) - a sole caregiver assisting in all three domains. 'Solo-Diverse' caregivers were less likely to be employed and had higher depressive symptoms relative to 'Shared-Diverse' primary family caregivers. The predominance of caregiving task sharing patterns involving multiple caregivers calls for expansion of research, policies, and programs beyond primary caregivers. Greater attention should be given to how families and live-in hired workers share caregiving tasks for older adults, and how this varies across cultural settings, especially in familial Asian societies. The findings further highlight the vulnerabilities of solo caregivers, whose employment capacity and mental health may be adversely affected by their caregiving duties. Policymakers should ensure that solo caregivers have access to support programs that address their financial and mental health needs.

Optimal functioning after early mild traumatic brain injury: Evolution and predictors.

Early mild traumatic brain injury (mTBI or concussion sustained between 0 and 5 years old) can lead to post-concussive symptoms, behavioral changes, and cognitive difficulties. Although school-age children (6-17 years old) experience similar consequences, severe neuropsychological deficits are not common, and the majority have no persisting symptoms after one month. Thus, there may be value in focusing on what characterizes optimal functioning (or wellness) after mTBI, but this has not been explored in young children. This study documents the evolution and predictors of optimal functioning after early mTBI. Participants were 190 children aged 18 - 60 months with mTBI (n = 69), orthopedic injury (OI; n = 50), or typical development (TDC; n = 71). Optimal functioning was defined as: (1) no clinically significant behavioral problems; (2) no cognitive difficulties; (3) no persisting post-concussive symptoms; (4) average quality of life or better. Predictors related to sociodemographic, injury, child, and caregiver characteristics included number of acute symptoms, child sex, age, temperament, maternal education, parent-child attachment and interaction quality, and parenting stress. Fewer children with mTBI had optimal functioning over 6 and 18-months post-injury compared to those with OI and TDC. Higher parent-child interaction quality and lower child negative affectivity temperament independently predicted optimal functioning. Children who sustain early mTBI are less likely to exhibit optimal functioning thantheir peers in the long-term. Parent-child interaction quality could be a potential intervention target for promoting optimal function.

Abstract 4135206: Patterns of Lifestyle Risk Behaviors for Cardiovascular Disease in Family Caregivers: A Latent Class Analysis

Introduction: Lifestyle risk behaviors for cardiovascular disease (CVD) often co-occur. However, little is known about their behavioral patterns among family caregivers, a population at high risk for CVD. Aims: To identify distinct latent classes of caregivers of lifestyle risk behaviors for CVD and to examine the individual characteristics associated with membership in the identified latent classes. Methods: This study included 643 unpaid family caregivers from the 2019 Health Information National Trends Survey 5 Cycle 3. The assessed lifestyle risk behaviors included cigarette use, non-abstinence from alcohol, low physical activity, long sedentary time, and low fruit and vegetable consumption. These behaviors were dichotomized based on established guidelines or cut-off points. Latent class analysis was performed to identify latent classes based on these lifestyle risk behaviors among caregivers. Subsequently, multinomial logistic regression was used to investigate socio-demographic, health-related, and caregiving characteristics associated with the latent class membership. Results: Three distinct classes were identified (mean age = 55±16 years; 59.3% female; 57.1% non-Hispanic white): “overall healthy, but non-abstainer” (Class 1, 17.1%; reference), “overall unhealthy” (Class 2, 64.1%), and “inactive, but healthy eaters” (Class 3, 18.8%). In unadjusted multinomial logistic regression models, caregivers reporting greater financial hardship (relative risk ratio [95% CI] = 2.5 [1.0-5.9]), higher psychological distress (3.7 [1.9-7.3]), poorer sleep quality (3.3 [1.6-6.8]), longer caregiving hours (2.1 [1.1-3.9]), and providing dementia care (2.3 [1.3-4.3]) were more likely to belong to Class 2, relative to Class 1. In the adjusted model including the significant characteristics above and controlling for age and gender, psychological distress (2.7 [1.2-5.9]) remained significant. No characteristics were significantly associated with membership in Class 3, relative to Class 1. Conclusions: Lifestyle risk behaviors for CVD among caregivers may cluster in distinct patterns that vary by individual characteristics. Caregivers experiencing psychological distress may be particularly at risk for engaging in lifestyle risk behaviors. Our novel findings underscore the importance of adaptive lifestyle modification interventions that target caregiver subgroups with different patterns of health behaviors to promote their cardiovascular health.

Use of Child Restraint Systems in Thailand and Factors associated with it: A Cross-Sectional Study

Objective: To determine the use of child restraint systems among caregivers of children in Thailand and to identify factors associated with it. Materials and Methods: Caregivers of children under 12 years old who utilized medical services at Lampang Hospital between March 2023 and March 2024 were asked to participate in this cross-sectional study. Data on characteristics of child and caregiver, driving behavior, and knowledge about child restraint systems were collected via a questionnaire. Multivariable regression was applied to analyze associated factors. Results: Of the 322 eligible caregivers, 279 (86.6%) participated, of which 127(44.5%) used a child restraint system. A higher caregiver education level (odds ratio [OR] 2.28, 95% CI 1.18; 4.39), and driving 3–7 days per week (OR 3.92, 95% CI 1.82; 8.40) were associated with more frequent restraint use. A higher age of the child (OR 0.97, 95% CI 0.96; 0.98) was associated with less frequent restraint use. Conclusion: Fewer than half of the caregivers utilized child restraint systems. Higher caregiver education levels and more frequent driving were associated with more frequent use, while older child age was associated with less frequent use of child restraint systems. Targeted interventions are needed to improve the use of child restraint systems.

Caregiver and Youth Characteristics That Influence Trust in Digital Health Platforms in Pediatric Care: Mixed Methods Study.

Combining patient-generated health data and digital health platforms may improve patient experience and population health, mitigate rising health care costs, reduce clinician burnout, and enable health equity. However, lack of trust may be a notable barrier to the data-sharing required by such platforms. Understanding sociodemographic, health, and personal characteristics will enable developers and implementers of such technologies to consider these in their technical design requirements. This study aims to understand relationships between sociodemographic characteristics of caregivers of children or adolescents and trust in and willingness to use digital platforms to store and share personal health information for clinical care and research. This study used a mixed methods approach, including surveys of caregivers of youth aged <18 years living in Canada or the United States and youth aged 16 to 17 years living in Canada, as well as web-based bulletin board discussions to further explore topics of trust in data sharing. Sociodemographic and survey data were tabulated and explored using proportional odds ordinal regression models. Comments from web-based group discussions were analyzed thematically using a coding approach to identify issues important to the participants. Survey data from 1128 caregivers (female participants: n=549, 48.7%; 36-50 years old: n=660, 58.5%; Canadian: n=603, 53.5%; urban population: n=494, 43.8%) were collected, of which 685 (60.7%) completed all questions. Data from 173 youth (female participants: n=73, 42.2%; urban population: n=94, 54.3%) were collected, of which 129 (74.6%) completed all questions, and data were available for analysis. Furthermore, among 40 participants, 23 (58%) caregivers contributed to the web-based discussion boards. Related to trust, living in a rural area (vs urban; odds ratio [OR] 0.66, 95% CI 0.46-0.95) resulted in lower concern for data privacy and security, while having an undergraduate (OR 1.82, 95% CI 1.30-2.55) or graduate degree (vs secondary or trade school; OR 2.50, 95% CI 1.68-3.73) resulted in higher levels of concern. Living with a chronic disease (OR 1.81, 95% CI 1.35-2.44) increased levels of concern regarding data privacy and security. Interestingly, those with chronic disease were more willing to use digital platforms for clinical care and share personal health information for not-for-profit research. Caregivers were most concerned about data breaches involving data from their children but also highlighted that digital platforms would allow for better coordination of care for their children. Our research confirms the willingness of caregivers and youth to use digital platforms for both clinical care delivery and research and suggests that the value of a digital platform may outweigh the risks of its use. Engagement of end users in co-designing such platforms has the potential to enhance digital trust. However, digital trust varies across sociodemographic groups; therefore, diverse end user engagement is necessary when designing digital applications.

Race Differences in Purpose in Life Among Family Caregivers: Findings From the Caregiving Transitions Study.

Family caregiving may affect purpose in life, defined as the sense that life has meaning and intentionality. Few studies have compared caregivers to non-caregivers or examined the characteristics of caregivers associated with purpose in life. Using data from the Caregiving Transitions Study (n = 486), we conducted multiple linear regression analyses to test the effects of caregiver status, age, gender, social network, and physical and mental health on purpose in life. We also tested whether the effect of caregiver status differed by race and, among caregivers (n = 241), the associations between caregiving characteristics and purpose in life. Caregivers did not differ significantly from non-caregivers in purpose in life in adjusted analysis. Among caregivers, significantly greater purpose of life was observed among Black caregivers and those reporting higher positive aspects of caregiving. Future research should examine these issues longitudinally, and caregiver interventions should consider addressing purpose in life and positive aspects of caregiving.

Intensity of care and the health status of caregivers to elderly rural South Africans.

Informal caregivers play an indispensable role in and are often the sole source of care for older adults in low and middle-income settings worldwide. Intensive informal care predicts mortality and morbidity among caregivers in higher-income settings. However, there is limited evidence from poorer settings, including Africa countries, where caregiving is shared widely, including across generations. We therefore investigated caregivers' health status in rural South Africa. We conducted quantitative interviews with all household members and all non-household caregivers aged ≥12 (n=1012) of 106 older adults in rural Mpumalanga, South Africa. We used multivariable regression with care-recipient random intercepts to assess the relationships between four caregiving characteristics and both self-reported chronic conditions and self-reported health status, considering how caregiver age moderated each association. Over half of all caregivers reported at least one chronic health condition, despite half being aged under 40. Caregivers self-reporting the worst health status provided high hours of care. However, caregivers' health status was not significantly associated with weekly care quantity or history of caring. Those aged ≥40 who reported being a main caregiver had 52% increased odds of reporting poorer health compared to other same-aged carers (95% confidence interval: 0.99, 2.35), while having more chronic conditions was associated with being expected to act as a sole caregiver more often among caregivers aged ≤39. Greater caring responsibilities for older adults were not consistently associated with caregivers' health in a setting where poor health is common, and caregiving is spread widely. Longitudinal data is necessary to unpack possible explanations of these findings, and to determine whether intensive caregiving speeds downward health trajectories for carers.

Factors associated with caregiver burden among family members of persons with schizophrenia in urban communities of China.

Family caregivers bear a heavy burden while providing care for those with schizophrenia, and they frequently play an important role in this regard. The present study examined the degree of caregiver burden and characteristics related to it among family caregivers of persons with schizophrenia in Chinese urban settings. Between August 2023 and June 2024, a cross-sectional study was conducted of 401 family caregivers of persons with schizophrenia living in metropolitan settings. The following measures were administered: the Zarit Burden interview (ZBI), General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS), and Simplified Coping Style Questionnaire (SCSQ). Linear regression analyses were used to identify independent correlates of caregiver burden. Family caregivers of persons with schizophrenia had an average ZBI score of 32.90(SD = 17.53) on a 0-88 scale, with the majority (80.0%) reporting moderate caregiver burden (scores of 21-39). The person with schizophrenia's marital status (not married), impulsive or aggressive conduct in the previous year, the caregiver's physical health (poor), and not having multiple caregivers were all independent correlates of caregiver burden. Family caregivers of persons with schizophrenia experience a moderate level of caregiver burden. To lessen the psychological suffering of and strain on caregivers, it is important to intervene early on impulsive and aggressive conduct of persons with schizophrenia, effectively treat physical health problems of caregivers, and strengthen the social support system or otherwise provide assistance to those caring for persons with schizophrenia.

Adherence to referral advice and its associated factors among community drug distributors and caregiver during SMC implementation in nine states

BackgroundMalaria is a global public health problem that disproportionately affects under-five children in poor resource countries. Nigeria accounted for the highest burden of malaria in Western Africa. Thus, seasonal malaria chemoprevention (SMC) programmes have been recommended and have been implemented across 9 states (Bauchi, Borno, FCT, Kebbi, Kogi, Nasarawa, Plateau, Oyo and Sokoto) in Nigeria. The study aims to measure the adherence to referral protocol and its associated factors among community drug distributors (CDs) and caregivers during SMC implementation in nine states.MethodsThe data of caregiver-child pairs that were identified with fever during the cycle one SMC implementation was extracted from the End-of-cycle (EoC) surveys carried out following cycles one SMC implementation in the study states. The surveys were completed within two weeks of the completion of SMC cycle one. Mixed-effects multivariable logistic regression models were fitted to explore the factors associated with adherence to referrals among caregivers-child pairs.ResultsThe socio-demographic characteristics of caregiver considered in the model were not found to be significantly associated with children down with fever taking to hospital for treatment, however the caregiver whose child was referred by CDs had significantly higher odds of seeking healthcare compared to those that were not referred (OR: 1.892, 95% CI 1.081–3.310, p = 0.025). There are higher odds of children seeking treatment among those that were referred by CDs.ConclusionThe study's findings shed light on the adherence to referral advice and the factors influencing caregiver behaviour during SMC implementation. Referral of sick child during SMC campaign appears to ensure health-seeking for malaria case management among caregivers-child peer in target communities.

An Investigation into the Current Status of Social Support for the Rehabilitation of Children with Disabilities in Chongqing

This study employed the self-developed 'Chongqing Children with Disabilities Rehabilitation Social Support Questionnaire' to assess the current state of social support received by families with children with disabilities during their rehabilitation in Chongqing, yielding valid responses from a total of 1,394 families. The findings indicate that the types of social support accessed by these families-ranked by average score-include instrumental support, emotional support, and informational support, with an overall tendency towards 'occasional' assistance. Furthermore, regarding sources of support, formal social assistance was rated higher than informal options; however, both were categorized between ‘not at all’ and ‘some assistance’. Additionally, significant differences were observed in relation to factors influencing support levels such as the primary caregiver's characteristics (including educational attainment and employment status), as well as the child's age, type and severity of disability.

Intersectionality and Caregiving: The Exclusion Experience and Coping Resources of Immigrant Women Caring for a Family Member With Severe Mental Illness.

Intersectionality has become a central analytical framework in the study of exclusion and empowerment experiences among women from marginalized communities. However, the relevance of intersectionality to informal caregiving in mental healthcare has hardly been explored to date. The purpose of the current study is to examine the exclusion experiences and coping resources of immigrant women caring for a family member with a severe mental illness (SMI) through the lens of intersectionality theory. Semi-structured in-depth interviews were conducted with 26 informal female immigrant caregivers from the former Soviet Union residing in Israel. The interviews were analyzed using a qualitative content approach. The findings revealed that the participants experienced stigma and exclusion in several intersecting categories: economic marginalization of immigrant single mothers, ethnic and gender-based stigma of Russian-speaking women, gender-based domestic violence, and mental health stigma by professionals. The participants' coping resources included spirituality and religious faith, support groups, and social activism. The study provides insights into the burdens and rewards experienced by female immigrant caregivers of family members with SMI through the lens of intersectionality theory. Implications for adapting services to the contextual characteristics of female immigrant caregivers and minimizing intersectional stigma and inequities in informal healthcare are discussed.

Experiences of empathy of caregivers caring for persons with dementia: a qualitative systematic review protocol.

The aim of this systematic review will be to explore the experiences of empathy in informal caregivers caring for persons with dementia. Positive caregiving experiences of informal caregivers caring for persons with dementia have many beneficial outcomes, such as improved well-being of both caregivers and care receivers and a higher quality of care for the persons with dementia. Empathy is a factor associated with positive caregiving experiences and is strongly correlated with reduced depression and reduced anxiety in informal caregivers of persons with dementia. Therefore, it is essential to understand the experiences of empathy, especially the caregiver characteristics such as their caring behaviors, relationship with the patient, and cultural beliefs. This review will include studies on the empathy experiences of informal caregivers caring for persons with any type of dementia. It will consider qualitative studies, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, and feminist research. This study will follow the JBI guidance for systematic reviews of qualitative evidence and will use the meta-aggregation approach to synthesise qualitative studies. The search strategy will aim to locate both published and unpublished studies in English, Chinese, and Thai, with no date restrictions. Methodological quality will be evaluated using the standard JBI critical appraisal checklist for qualitative research. The findings will be pooled using the meta-aggregation approach or will be presented in narrative format. PROSPERO CRD42023490472.

Effectiveness of an mHealth App That Uses Financial Incentives and Gamification to Promote Health Behavior Change in Adolescents and Caregivers: Protocol for a Clinic-Based Randomized Controlled Trial.

Adolescent and adult obesity continues to be a public health epidemic in the United States. Despite the popularity of mHealth apps with gamification among adolescents, there are insufficient studies to evaluate the efficacy of gamified mHealth apps and financial incentives to motivate sustained health behavior change in adolescents or their adult caregivers. This study aims to evaluate the effectiveness of gamification techniques and financial incentives used in the novel "CommitFit" mHealth app to motivate health behavior change and improve various mental and physical health metrics in adolescents and their caregivers. This study is a 3-month randomized controlled trial (RCT) with 30 adolescents (aged 13-15 years) and their adult caregivers (N=60). It evaluates "CommitFit," which uses gamification including points and leaderboards to motivate logging and achievement of self-selected health behavior goals (eg, more water, sleep, physical activity, fruits, or vegetables or fewer sugary beverages). The RCT had three arms, each with 10 dyads: (1) CommitFit-only users; (2) CommitFit$, where adolescents were paid US $0.05 for each point they earned; and (3) waitlist control. Intervention dyads used the app for 3 months and had the option to use it for the fourth month without prompts or extra financial incentives. User analytic software was used to evaluate the frequency of user logs and goal achievement. Monthly surveys evaluated self-reported change in the 5 CommitFit health behaviors. Changes in BMI and blood pressure were evaluated for all participants at 3 clinical visits. Mental health, gamification, and behavior economics surveys were completed during the clinical visits. Recruitment began in August 2023 and was completed in 10 weeks. The research team successfully recruited and enrolled 30 dyads. Researchers emailed and called 89 caregivers on a physician-approved adolescent patient list, a 33% recruitment rate. Data collection and analysis will be conducted in the spring and summer of 2024. The results of this study are anticipated to be published between late 2024 and early 2025. This RCT will expand knowledge of the effectiveness of gamification techniques, financial incentives, and mHealth apps to motivate sustained health behavior change among adolescents and caregivers. These results may offer new opportunities to caregivers, health insurers, health care systems, and clinicians to motivate health behavior change in adolescents and caregivers, with the ultimate goal of preventing or reducing obesity and obesity-related diseases. Additional gamification, mental health surveys, and app user analytics included in the study may provide further insight into the characteristics of adolescents or caregivers who would benefit the most from using a gamified mHealth app like CommitFit. DERR1-10.2196/63505.

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.

Harm to children from others' drinking: A survey of caregivers in Australia.

This study aimed to identify the prevalence and types of harm to children from others' drinking in Australia, as indicated by caregivers, and examine socio-demographic characteristics of caregivers who indicated a child was affected by others' drinking. A subsample of 854 adult respondents, who were caregivers of children under 18 years from the 2021 Australian Alcohol's Harm to Others study, were asked questions about whether children in their care had been negatively affected by others' drinking in the past year. Weighted prevalence estimates of overall and specific harms to children are presented. Logistic regressions were conducted to determine characteristics associated with indicating harms to children from others' drinking. Over 17% of caregivers (95% confidence interval [CI] = 13.0-19.0) indicated that one or more children in their care had been affected by others' drinking in the past 12 months. Verbal abuse (6.2%; 95% CI = 4.3-8.3) was the most common harm indicated, followed by financial harm (4.3%; 95% CI = 2.7-6.2). One percent of caregivers (95% CI = 0.4-2.3) indicated a child was physically hurt and less than 1% (95% CI = 0.2-1.4) indicated a child was the subject of a child protection call due to someone's drinking. Women and caregivers over 65 years were more likely to indicate a child had been affected compared with men and caregivers under 65 years. Caregivers who drank five or more drinks at least three times per week were four times more likely to indicate a child was affected compared with abstainers. Living in a household with someone who drinks heavily and who had negatively affected the child's caregiver was associated with an increased likelihood of child harm. In 2021, a weighted survey estimate for caregivers in Australia indicated that almost one in six children had been affected by others' drinking. Heavier drinking of caregivers and other household members was the most substantial predictor for indicating a child had been negatively affected by others' drinking.

Using the role model approach to optimise caregiver administration of sulfadoxine-pyrimethamine amodiaquine to children aged 3–59 months in Burkina Faso, Chad and Togo: findings from an evaluation

BackgroundSeasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention for the prevention of malaria among children at high risk in areas with seasonal transmission. During the coronavirus disease 2019 (COVID-19) pandemic, SMC drug distribution was rapidly adapted to reduce contact and mitigate the risk of transmission between communities and community distributors, with caregivers administering doses. To address the challenges and find local solutions to improve administration and adherence, the role model approach was designed, implemented and evaluated in selected communities of Burkina Faso, Chad and Togo. This paper describes the results of this evaluation.MethodsFocus group discussions were held with primary caregivers in all three countries to understand their perceptions of the approach’s acceptability and feasibility. In Burkina Faso and Togo, household surveys assessed the characteristics of caregivers reached by role model activities. Key indicators on SMC coverage and adherence allowed for an assessment of caregiver engagement outcomes related to participation in activities. Statistical associations between participation in study’s activities and caregiver beliefs related to SMC had been tested.ResultsThe majority of caregivers believed the approach to have a positive effect on drug administration, with most adopting the promoted strategies. Greater involvement of fathers in drug administration and acknowledgement of their joint responsibility was a notable positive outcome. However, several barriers to participation were noted and there was criticism of the group approach. In Burkina Faso and Togo, end-of-round survey results revealed that 98.4% of respondents agreed the approach improved their knowledge and skills in malaria prevention, while 100% expressed a desire to continue practicing the behaviours learned. However, there was a relatively low level of awareness of the approach among communities. Participation was strongly associated with participants’ self-reported belief in ease of remembering to administer, and ease of administering, SMC medicines.ConclusionCaregivers perceived the role model approach to be beneficial in aiding drug administration, with other positive impacts also reported. Replication and scale-up should utilize the most popular communication channels and existing community structures to ensure activities are promoted effectively. A mixture of group and one-on-one approaches should be used where appropriate and feasible.

Fundamental movement skills proficiency in preschool-aged boys and girls: Family matters

ABSTRACT To investigate the associations of fundamental movement skill (FMS) proficiency with family factors, including socioeconomic status (SES) and caregiver characteristics, by sex in young children in China. Participants included 1,207 Chinese children aged 3–6 years in this cross-sectional study. Children’s FMS, consisting of locomotor skills and object control (OC) skills, were assessed. Information on family SES and caregiver characteristics was reported by the parents. Sex differences in outcomes and the associations of FMS with family factors by sex were examined using SPSS 26.0. Boys scored significantly higher than girls in terms of overall FMS and OC skills (both p < 0.01). There were significant and negative associations between children’s FMS and parental education level and parental body mass index (BMI), which varied by sex. Boys who were regularly cared for by parents had higher FMS and OC skill scores than did those who were primarily looked after by grandparents (both p < 0.01). This complex interplay between sex and family factors (i.e. parental education level, parental BMI, and the identity of primary caregiver) on FMS proficiency in young children underscores the urgent need for developing sex-tailored, family-involved, and socio-culturally adapted interventions to enhance FMS proficiency at the preschool stage.

Versorgungsqualität und -sicherheit nach Implantation eines Linksherzunterstützungssystems: eine qualitative Studie zur Patient*innenperspektive auf relevante Versorgungsaspekte

IntroductionImplantation of a left ventricular assist device (LVAD) requires extensive aftercare. It is largely unclear how aftercare should be designed from the patients’ perspective. Implications can be developed based on an examination of the healthcare context. Its main components are mapped on five tiers in the Human Factors of Home Health Care Model by Henriksen, Joseph, and Zayas-Caban (2009). Using this model, the present study explores the patient perspective on the context of healthcare after an LVAD implantation. MethodsWe employed a qualitative cross-sectional study, in which LVAD patients participated in semi-structured interviews. The transcribed interviews were analyzed using content analysis. First, relevant meaning units were identified and deductively categorized into the model. Then, categories of care-related aspects were developed inductively within each of the model tiers. ResultsWe interviewed 18 patients aged 33 to 78 years who had been living with the LVAD between a few weeks and more than 10 years. Twenty-eight categories related to care aspects were developed within the model tiers: 3 categories on patient characteristics (e.g., self-management skills), 3 on caregiver characteristics (e.g., professionalism), 11 healthcare-related tasks and requirements (e.g., wound management), 8 on factors of the physical environment (e.g., controllability), medical devices and technologies (e.g., carrying systems for external components), and cultural, social and community environment (e.g., interaction with peers), as well as 3 on external environmental factors (e.g., healthcare infrastructure). DiscussionThe present study represents the first investigation focusing on aspects of the healthcare context influencing healthcare quality and safety from the perspective of LVAD patients in Germany. LVAD aftercare covers a broad and complex range of tasks. For this, patients, caregivers and healthcare professionals need specific knowledge, which is lacking in various respects. In the first place, this is compensated by the patients’ own initiative and the personal care provided by the VAD outpatient clinics. ConclusionThree key recommendations to optimize aftercare from the patient perspective are derived: Patients would benefit from a more flexible and decentralized aftercare concept, to which telemedicine could contribute. LVAD-specific expertise among general healthcare providers is perceived as insufficient by patients and could be strengthened through training and counseling services. The broad scope of tasks and the high level of responsibilities in LVAD aftercare pose challenges for patients and their families, which could be addressed through continuous information and training programs.

Caregiver burden, hopelessness, and anxiety: Association between sociodemographic and clinical profiles of patients with stroke

ObjectivesThis study aimed to evaluate the association between the sociodemographic characteristics of caregivers and patients with stroke, clinical data on stroke, and disability with caregiver burden, hopelessness, and anxiety. Materials and methodsThis cross-sectional study included patients with stroke of either sex, aged >18 years. Data were collected between January 2020 and July 2021. Patient demographic included age, sex, stroke type, severity, etiology, topography, treatment, and stroke recurrence. Stroke disability was assessed using the modified Rankin Scale and Barthel Index at 90 days post-discharge. Additionally, caregiver burden, hopelessness, and anxiety were evaluated during patient consultations using the Zarit Burden Interview (ZBI), Beck Hopelessness Scale (BHS), and Beck Anxiety Inventory (BAI). ResultsWe included 104 patients with stroke and their caregivers. Overall caregiver burden was moderate (ZBI: 24 [25]), with mild hopelessness (BHS: 4 [4]) and minimal to mild anxiety (BAI: 8 [13]). The linear regression model presented in Table 3 showed that female caregivers scored up to 11 points higher on the Zarit Burden Interview (p = 0.011). Additionally, increased patient age was associated with a higher caregiver burden (p = 0.002) on the Zarit Burden Interview. Posterior circulation stroke and total anterior circulation stroke were also associated with higher Zarit Burden Interview scores compared to lacunar stroke (p = 0.017). Age was not associated with caregiver burden in the entire sample. However, an association between age and caregiver burden was found only in the female group. Furthermore, women aged 65 years and older experienced a more severe burden than women aged 18 to 64 years (p<0.001). Stroke disability was not associated with caregiver burden. ConclusionsOlder female caregivers were significantly affected when caring for stroke patients. Total anterior circulation stroke and Posterior circulation stroke increased Zarit Burden Interview scores. However, no association was observed between stroke disability and the caregiver burden.

Characteristics of Informal Caregivers and Social Participation of People With Dementia.

Social participation is associated with increased quality of life and well-being but declines following the onset of dementia. Informal caregivers may facilitate social participation among people with dementia. This study aims to identify characteristics of informal caregivers associated with social participation of people with dementia in valued activities. This cross-sectional study used data from the 2011, 2015, and 2017 National Health and Aging Trends Study (NHATS) and the National Study of Caregiving. NHATS respondents with possible or probable dementia and an informalcaregiver were included (N = 1,060). Respondents were asked whether they participated in each of 5 social activities during the past month. Valued activities were considered somewhat or very important. Survey-weighted logistic regression models were computed to identify characteristics of primary informal caregivers associated with participation of people with dementia in social activities. Social participation of people with dementia was not independently associated with sociodemographic variables or relationship to the primary caregiver (spouse/partner, adult child, or other relative/nonrelative). Social participation of primary caregivers was associated with increased participation of people with dementia in the same activity for visiting friends/family (odds ratio [OR] = 1.88, p = .016), attending religious services (OR = 4.82, p < .001), and volunteering (OR = 3.25, p = .015), whereas greater caregiver external support was associated with increased participation of people with dementia in organized activities (OR = 1.37, p = .022). Assets of informal primary caregivers found to promote social participation of people with dementia include traveling to the person with dementia's home, being socially active themselves, and utilizing support services.