Caregiving Relationship Research Articles

Psychological Risk and Protective Factors for the Development of Prolonged Grief in Mourners

Objective: This study aims to analyze the relationships between stressful life events (SLEs), social support, psychopathology, and attachment in the bereavement process. We focus on predicting the risk of prolonged grief in bereaved caregivers of palliative patients and relatives of patients who died from sudden cardiac death, using complementary methodologies: regression models and Qualitative Comparative Analysis (QCA). Methodology: Sample was 150 bereaved caregivers of palliative patients and relatives of patients who died from sudden cardiac death. Participants completed questionnaires assessing these factors. Results: Nearly half of the participants were at moderate-high risk for prolonged grief. Bereavement risk was negatively associated with instrumental and emotional social support and positively correlated with psychopathology and SLE. Hierarchical regression analysis explained 21.40% of the variance in prolonged grief risk, while QCA models identified high levels of psychopathology and perceived SLE as significant predictors. Conversely, secure attachment and strong social support were linked to lower risk. Conclusion: The findings underscore the importance of personalized support programs to enhance caregivers’ well-being during bereavement.

Effect of a Peaceful End-of-Life Care Program on Perceived Good Death in People With Advanced Cancer and Their Family Caregivers.

Early integration of palliative care benefits both people with advanced cancer and their family caregivers, yet research on holistic end-of-life care and advance care planning remains limited. The primary objective of this study was to examine the effect of a peaceful end-of-life care program on perceived good death outcomes in people with advanced cancer and their family caregivers. Secondary objectives included exploring the program's effect on the quality relationship and end-of-life care knowledge among family caregivers. In this quasi-experimental design with repeated measures, 122 participants were enrolled. On the basis of the Theory of the Peaceful End of Life, the experimental group received a 4-week program comprising health education, self-care for symptom management, advance care planning, psychosocial support, and family involvement plus standard care, whereas the control group received standard care alone. The Good Death Inventory was the primary measurement tool. The results showed a significant improvement in perceived good death, quality relationships, and end-of-life care knowledge in the experimental group, with no such improvements observed in the control group. The program improved good death outcomes, caregiver relationships, and end-of-life care knowledge. Therefore, early initiation of this program is recommended to optimize its benefits.

Association Between a Family Caregiver's Relationship to Persons With Dementia and Cardiovascular Disease by Race and Ethnicity: A Secondary Analysis of the Behavioral Risk Factor Surveillance System Data.

Caregiver stress is linked to key mechanisms for developing cardiovascular disease and the burden differs by caregiving relationship (eg, spouse). Furthermore, cardiovascular disease risk in family caregivers (FCGs) has been shown to differ by race and ethnicity. However, little is known about whether the association between caregiving relationship and FCGs' cardiovascular health differs by race and ethnicity. This study examined the association between an FCG's relationship to persons with dementia and risk factors for cardiovascular disease and cardiovascular disease conditions and identified how these associations differed by race and ethnicity in FCGs. This was a secondary analysis of the 2015-2020 Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System data. Logistic regression models were used to examine the associations between predictors (caregiving relationship, race/ethnicity, and their interaction) and outcomes (cardiovascular disease risk and conditions). A sample of 6042 FCGs of persons with dementia were included. When analyzing race/ethnicity groups as a whole, cardiovascular disease risk and conditions differed significantly by caregiving relationship. Notably, spouse caregivers were at higher risk of diabetes, stroke, angina, and myocardial infarction, while showing lower rates of current smoking, heavy drinking, and obesity, compared to adult children. The associations between caregiving relationship and select cardiovascular disease risk factors (depression, previous smoking) differed significantly between racial and ethnic groups. There is a need to develop culturally appropriate cardiovascular preventive health care strategies that reduce cardiovascular disease risks by considering caregiving relationship. Research is especially needed among minoritized racial and ethnic FCG groups.

Caregiving Satisfaction, Psychological Distress and Caregiver Burden in Family Caregivers of Dependent Older People: A Longitudinal Study.

Although a substantial amount of research has focused on negative aspects of caregiving, less research has been conducted investigating positive aspects of providing informal care. The aim of this study was to investigate the longitudinal association between caregiving satisfaction and psychological distress in informal carers of dependent older people, and whether this relationship is mediated by caregiver burden. Prospective longitudinal study with a probabilistic sample of 332 caregivers of older relatives, with data collected at baseline and at 1-year follow-up. We measured caregiving satisfaction, psychological distress, subjective caregiver burden and several covariates (caregivers' sex, age and objective caregiver burden). Data were analysed using generalised estimation equations with multiple imputation. The STROBE checklist was used to support the writing of this document. After controlling for covariates, caregiving satisfaction was significantly negatively associated with lower levels of subjective caregiver burden (B = -0.17, 95% CI: -0.23, -0.11) and emotional distress (B = -0.23, 95% CI: -0.36, -0.11). When subjective burden was included in the model, the relationship between caregiving satisfaction and psychological distress was no longer significant (B = -0.11, 95% CI: -0.23, 0.02), whereas the association between subjective burden and psychological distress remained (B = 0.75, 95% CI: 0.57, 0.92). The Sobel test confirmed these results (p < 0.001), indicating that subjective caregiver burden mediates the relationship between caregiving satisfaction and psychological distress (complete mediation) over time. Caregiving satisfaction exerts a longitudinal protective effect on carers' psychological distress via subjective burden. Our findings indicate that interventions aimed at strengthening caregiving satisfaction may play a significant role in maintaining positive mental health outcomes for informal caregivers.

PERSONALITY TRAITS AS PREDICTORS OF BURNOUT IN SANDWICH GENERATION CAREGIVERS

Abstract Informal caregiving increases the risk for burnout (i.e., emotional exhaustion, detachedness in caregiving relationships, reduced sense of accomplishment through helping). Sandwich generation caregivers, individuals who provide care for their children and older parents, face unique challenges and experience greater burnout than individuals caring for children alone. However, little research has examined what factors are associated with outcomes such as burnout in sandwich generation caregivers. Furthermore, studies on sandwich generation caregivers rarely utilize a resiliency-based approach. This study aimed to examine whether Big Five personality traits (i.e., openness, conscientiousness, extraversion, agreeableness, neuroticism) predicted burnout in sandwich generation caregivers (N = 102). A hierarchical regression model controlling for demographics, R² =.007, F(3, 98) =.222, p =.881, indicated that openness, conscientiousness, agreeableness, and neuroticism explained an additional 32.9% of the variance. This change in R² was significant, F(4, 94) = 11.628, p &amp;lt;.001, with openness (β = -.215), conscientiousness (β = -.265), and neuroticism (β =.257) the only significant independent predictors, R² =.336, F(7, 94) = 6.781, p &amp;lt;.001. In a different regression model, which controlled for depression, neuroticism was no longer a significant independent predictor. These results suggest that sandwich generation caregivers with higher levels of openness and conscientiousness and lower levels of neuroticism may experience lower levels of burnout. Findings from this study enhance our understanding of sandwich generation caregivers and what personality traits may serve as resiliency factors towards decreasing burnout. Further research can examine modifiable elements of these traits to increase resiliency.

CLINICAL APPROACHES TO SUPPORT MALE DEMENTIA FAMILY CAREGIVERS

Abstract Integrated Memory Care (IMC) is a primary care practice for people living with dementia and their family caregivers. The practice integrates geriatric medicine, dementia specialty care/cognitive neurology, and palliative care along with caregiver services including support groups, classes, and psychotherapy for individuals and families. Finally, the practice hosts various opportunities to participate in caregiving research. Since 2015, the practice has treated over 2500 people living with dementia (PLWD) and supported their family caregivers. The mean age of patients is 78.6 years, the majority (66%) are female, and 42% identify as a racial or ethnic minoritized group. Caregiver relationship to patients (PLWD) is divided evenly between spouse (48%) and adult child (48%) and their mean age is 65.3 years. Men serving as primary family caregiver differ from their female counterparts in choice of clinical services, engagement in caregiver-specific programs, and participation in research. Successful marketing approaches include emphasis on caregiver as hero archetype, a clear message of the return-on-investment of services and activities. This presentation will describe the experience of supporting and engaging men as dementia family caregivers using aggregated data from multiple pilot studies as well as direct input from current active caregivers and IMC program staff.

Toward Equitable Access to Psychosocial Screening in Canada: Validation of the French–Canadian Psychosocial Assessment Tool

ABSTRACTObjectiveThe Psychosocial Assessment Tool (PAT) is a brief caregiver report, family‐centered, psychosocial risk screening tool widely used in pediatrics and available in many languages. Although French is an official language of Canada, a French–Canadian version of the PAT has not yet been validated, which impedes access to this tool for family psychosocial screening. This study aimed to translate, adapt as necessary, and validate the French–Canadian version of the PAT.MethodsThe PAT 3.0 was translated into French using the forward–backwards method. Interviews with healthcare workers (n = 5) and a focus group of parents of children newly diagnosed with cancer (n = 4) led to minor modifications to improve cultural adaptation and comprehensibility. Subsequently, 66 French‐speaking parents of children newly diagnosed with cancer participated in a quantitative validation study; completing the French–Canadian PAT and related caregiver measures.ResultsThe French–Canadian PAT has an overall internal consistency of KR‐20 = 0.64, with subscales ranging from 0.57 to 0.86. The total PAT score significantly correlated with the Distress Thermometer (r = 0.54). Congruent validity was demonstrated for most PAT subscales, except for Family Beliefs and Family Problems. The sample followed this distribution on the Pediatric Psychosocial Preventative Health Model: 21.2% universal, 53% targeted, and 25.8% clinical.ConclusionThe French–Canadian PAT provides insight into family psychosocial risk. This study is a step toward equitable access to care by providing French‐speaking families with access to a tool aligned with the psychosocial standards of care in pediatric oncology. Future research should focus on implementing the PAT in Canadian clinical settings.

Borderline Personality Disorder and Loneliness: Broadening the Scope of Treatment for Social Rehabilitation.

Borderline personality disorder (BPD) has been described as a condition of intolerance of aloneness. This characteristic drives distinguishing criteria, such as frantic efforts to avoid abandonment. Both BPD and loneliness are linked with elevated mortality risk and multiple negative health outcomes. Psychodynamic theories of BPD emphasize fundamental impairment in attachment and interpersonal functioning. Empirical research demonstrates an association between BPD diagnosis and increased loneliness. Individuals with BPD experience higher levels of loneliness than the general population, and their social networks are systematically smaller, less diverse, and less satisfying. Differences in the subjective experience of loneliness persist when controlling for these relevant social network features, indicating that people with BPD experience more loneliness than others in the same objective social circumstances. According to patients with BPD, increased social connection is often a primary treatment goal and marker of satisfying recovery. There are, however, few evidence-based approaches that primarily target loneliness and building life structures that support durable connections with others. Therefore, loneliness persists as an intractable problem, often failing to remit alongside other symptoms, and few resources are routinely implemented to address this problem. In this article, we argue that loneliness is central to the symptomatic oscillations and subjective experiences of many patients with BPD. We propose that treatment extend beyond the overemphasized therapeutic alliance relationship to also promote socialization and group and vocational settings to enhance patients' social networks. Building larger social networks that rely less on exclusive caregiving and/or romantic relationships and more on role-bound identity building and community relationships would more directly target long-term identity diffusion and relational instability. Such interventions can harness nonclinical community resources, such as group treatment, vocational supports, and peer supports.

Carer Outcomes From a Residential Treatment Service for Eating Disorders.

Eating disorders often result in distress, relationship impairment, and emotional, social, and financial burden for family members and other loved ones. However, carer outcomes from eating disorder treatment are under-researched, particularly residential settings. This study aimed to examine carer outcomes from a transdiagnostic residential service for eating disorders, which included therapist-led psychoeducation and peer support for carers. Measures of carer burden, accommodation and enabling of eating disorder symptoms, psychological distress, and health-related quality of life were completed at pre-treatment and three months' post-treatment by 51 carers (66.7% parents). Linear mixed effects modelling found significant improvement in carer burden (b=-5.80, p=0.033), accommodation and enabling of eating disorder symptoms (b=-13.32, p=0.003), and psychological distress (b=-3.19 p=0.026), with medium to large effect sizes (d=-0.76-1.32). Averaged across time, women reported significantly greater carer burden than men (b=12.42, p=0.011). Findings support the effectiveness of residential treatment for carers, including improvement in behaviours that are likely to support eating disorder recovery. Future research is needed to determine what elements in residential treatment, the caregiving relationship, and beyond contribute to these positive outcomes. The study was prospectively registered on the Australian and New Zealand Clinical Trials Registry in November 2021, registration number ACTRN12621001651875.

The Impact of Traumatic Dental Injury on the Oral Health-Related Quality of Life of Preschool Children: A Cross-Sectional Study.

The aim of this study was to investigate the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL) of preschool children, and further inform public oral health care policies and strategies for this age group TDI patients. This retrospective and cross-sectional study was conducted in the Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China. It included 314 children aged from 2 to 5 years, with 90 children diagnosed with TDIs and 224 without TDIs. Parents or primary caregivers completed questionnaires, and the responses were gathered for statistical analysis to evaluate the impact of TDIs. The OHRQoL was assessed using the Early Childhood Oral Health Impact Scale (ECOHIS). The total ECOHIS score and the scores for the 13 individual items were significantly higher in children with TDIs compared with those without TDI (p < 0.001). In the child impact section, eating and masticatory function were the most severely affected (40%), while most of parents experienced strong feelings of self-blame in the family impact section (61.1%). A positive correlation was observed between the number of injured teeth and the total ECOHIS score (p = 0.001), while the time elapsed since TDI indicates a negative correlation with the total ECOHIS score (p < 0.001). Additionally, children with severe TDIs had higher ECOHIS scores than those with mild TDIs, indicating a greater impact on OHRQoL (p = 0.006). In contrast, tooth discoloration, the caregiver's relationship to the child, caregiver education level and the position of the affected teeth did not significantly influence the total ECOHIS score (p > 0.05). TDIs have a significant impact on OHRQoL in preschool children, highlighting the need for greater societal attention. Strengthening preventive and proper treatment measures for TDIs, along with enhancing health education programs, is strongly recommended.

Social worlds of Appalachian women caregivers of older relatives living with dementia.

Over 11 million people in the United States provide care for an older family member with dementia, with this responsibility primarily falling on daughters and wives. In Appalachia, a mountainous region in the U.S characterized by close families, family members were crucial to ensuring that care needs were met for people living with dementia during the COVID-19 pandemic. However, we know little about the well-being of family caregivers during the public health crisis. Guided by a Limited Future Time Perspective postulate, which posits that as people age they begin to prioritize emotionally meaningful relationships over instrumental goals, we asked how dementia caregiving changes the social lives of family caregivers situated within kin networks; and how a public health crisis (i.e., COVID-19 pandemic) affects caregivers who are already at risk for social isolation and feelings of loneliness. Participants were recruited from a regional health care system and four Area Agencies on Aging. In our longitudinal study we invited family caregivers to be interviewed at multiple time points over a 4-year period. The sample for this study was women caregivers interviewed (N = 27; age range 32-81, m = 63). Interviewers followed a semi-structured protocol with questions designed to elicit descriptions about (a) changes in formal and informal support over time, (b) the person living with dementia's symptoms and disease progression, and (c) how the pandemic affected caregivers' and persons living with dementia's social worlds. We found three types of caregivers: (1) caregivers who had social lives interdependent with their relative with dementia, (2) caregivers and persons living with dementia whose social lives were restricted due to dementia symptoms and caregiving demands, and (3) caregivers and their relative living with dementia who maintained separate social lives. Dementia symptoms more than social distancing measures contributed to caregivers' shrinking social worlds particularly for those with interdependent social lives despite living amongst kin. This study is important in understanding how women in Appalachia fared during a pandemic in the context of dementia caregiving. This research supports the need for respite services and dementia care training for respite workers.

The Effects of Complex Family Dynamics on Early Childhood Development: A Case Study

This study was conducted to determine the effects of complex family dynamics on early childhood students' development. This study addresses the cognitive, social, emotional, moral, and coping mechanisms early childhood students adopt. A descriptive case study design and purposive sampling were utilized. Five respondents, from early childhood education nursery and kindergarten students, were interviewed face-to-face while observing proper health protocol. Utilizing Resiliency Theory and Carl Rogers' Self-Actualization framework, the study employed a descriptive case study design with structured interviews. Findings reveal challenges such as emotional neglect, isolation, and anxiety, counterbalanced by nurturing caregiver relationships and effective coping mechanisms. The majority of the students experience a lack of parental support and guidance due to diverse, complex family dynamics like blended families, single parenting, and families affected by divorce or separation. In addition, most of the students experience emotional difficulty, anxiety, loneliness, and isolation. Also, many of them need help socializing and following rules and regulations. Recommendations to improve these experiences include workshops and resources designed to foster parental involvement in their children’s education and emotional well-being and establishing mental health services in schools to offer counseling and support for children facing family-related challenges.

Perceived Social Support Mediates the Relationship Between Benefit Finding and Depressive Symptoms Among Young and Middle-Aged Stroke Survivors and Their Spouse Caregivers

Background Existing literature indicates that benefit finding and social support play protective roles against depressive symptoms. However, there is a lack of understanding regarding the interplay between benefit finding, social support, and depressive symptoms within the dyadic context of stroke survivor-spousal caregiver relationships. Objective The objective of this study is to investigate the relationships among benefit finding, social support, and depressive symptoms in young and middle-aged stroke survivors and their spouse caregivers. In addition, the mediating role of social support in the association between benefit finding and depressive symptoms is explored. Methods A total of 203 pairs of stroke survivor-spouse caregiver were included in the study. Depressive symptoms, social support, and benefit finding were measured using the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Benefit Finding Scale, and the Caregiver Benefit Finding Scale. The Actor-Partner Interdependence Mediation Model was used to assess direct and indirect effect. Results The findings revealed a significant negative association between higher levels of benefit finding and lower depressive symptoms in both stroke survivors (actor effect, −0.126) and spousal caregivers (partner effect, −0.044). Perceived social support emerged as a significant mediator in the relationship between benefit finding and depressive symptoms in spousal caregivers (indirect effect, −0.024). Furthermore, spousal caregivers' perceived social support served as a mediating variable between caregiver benefit finding and depressive symptoms in stroke survivors (indirect effect, −0.023). Conclusion The study underscores the interdependence between stroke survivors and spousal caregivers, highlighting the mutual influence they have on each other. Consequently, targeted interventions addressing both members of the dyad, with a focus on enhancing benefit finding and social support, could prove beneficial in ameliorating depressive symptoms in stroke survivor-spousal caregiver.

Conceptual Framework for African American Kinship Caregiver's Susceptibility to Alzheimer's Disease.

Kinship caregivers (e.g., grandparents raising grandchildren) have been increasing over the last several decades. Approximately 3.5 million grandparents and other relatives are the primary caregivers for their related children, and African Americans are more likely to be kinship caregivers than persons from other groups. Kinship caregivers face unique challenges, such as parenting for uncertain periods of time and often with insufficient financial resources and support, placing them at significant risk of stress. Given the findings linking chronic stress to Alzheimer's disease (AD), there is a need for research to identify possible stressors and mitigate risks for outcomes such as AD among kin caregivers. Additionally, research indicates that African Americans (AAs) experience unusually high levels of stress due to factors often associated with structural racism, and they are disproportionately affected by cardiovascular disease (CVD), which is often a consequence of stress and another risk factor for AD. Regrettably, AA kin caregivers often incur a host of negative stress-related outcomes, including poor physical and mental health. Thus, there is an urgent need for research to identify modifiable risk factors for both stress and CVD to potentially mitigate the onset of AD in this population. The purpose of this paper is to provide a conceptual framework to examine the links between African Americans who commit to the unselfish act of providing kinship caregiving and their susceptibility to AD. Future research should investigate modifiable mechanisms to reduce the risks of AD in African American caregivers.

Psychological distress in Asian American informal caregivers: an analysis by disaggregated ethnic groups

ABSTRACT Background: Despite Asians being the fastest-growing ethnic group in the US, most studies have focused on Asian Americans as an aggregate racial/ethnic group. The burden of mental health problems is increasing among caregivers due to population aging, yet little is known about the distress experienced by Asian caregivers when examined by disaggregated ethnic groups. Methods: Using 2019–2020 California Health Interview Survey data, we examined disparities in psychological well-beings between non-Hispanic White and Asian American adult caregivers, with an emphasis on understudied Asian ethnic groups. Psychological distress was measured using the Kessler 6 scale, with scores ≥6 indicating mental distress and ≥13 indicating serious mental illness. Multivariable logistic regression adjusted for socio-demographics, physical health, caregiving relationship, intensity of care, and care recipients’ characteristics. Results: The study included 8,722 caregivers (mean age, 58.7 years; 61.3% women; 14.1% Asian [379 Chinese, 260 Filipino, 167 Japanese, 138 South Asian, 105 Korean, 101 Vietnamese, 78 other Asian], 85.9% White). Overall, 26.8% had mental distress, and 8.5% had serious mental illness. Compared to White caregivers, Korean American caregivers had higher odds of mental distress (Odds Ratio [OR], 2.37; 95% CI, 1.47–3.82) and serious mental illness (OR, 2.15; 95% CI, 1.17–3.92), while Chinese (OR, 0.72; 95% CI, 0.55–0.95) and Japanese (OR, 0.67; 95% CI, 0.45–0.99) American caregivers had lower odds of mental distress. Korean American caregivers had the highest prevalence of mental distress (43.1%) and serious mental illness (15.3%), compared with White and other Asian American caregivers. Conclusion: Disaggregating data reveals significant mental health disparities among ethnic subgroups of Asian American caregivers. Tailored resources should address the distinct needs of ethnic subgroups of Asian American caregivers, considering language barriers, acculturation, and cultural norms that may exacerbate psychological distress.

“Learning to ‘waltz’ rather than ‘wrestle’ … ” : a novel, ultra-brief intervention supporting early child–caregiver relationships

ABSTRACT Introduction The quality of the early child–caregiver relationship plays a crucial role in shaping a child’s development. In response to the lack of early intervention provisions for 2–5 year olds, the Leeds Infant Mental Health Service increased their offer to support children up to their fifth birthday (and their caregivers), where relational difficulties impact upon the child’s emotional wellbeing. Aims This paper aims to evaluate the effectiveness of the direct therapeutic work (named ‘Understanding Your Toddler’; UYT), in promoting the child–caregiver relationship. Method Nineteen families were accepted for UYT, where there was motivation and emotional availability to consider change within the relationship. Thirteen families engaged in the work. The UYT offer adopted a three session, home-visiting model, drawing upon several therapeutic approaches. A two-phased mixed methods design was adopted. Phase I analysed quantitative changes within the relationship. Phase II qualitatively evaluated families and professionals’ experiences of UYT. Results Paired t-tests and Wilcoxon signed rank analyses illustrated significant differences pre and post UYT in caregiver: goals, confidence, perceptions and feelings of irritation. No significant differences were found in caregiver feelings of warmth. Themes from interviews suggested that the strengths-based approach was valued, and that video work supported caregivers to ‘see the world from their (toddlers’) point of view’. Conclusion This evaluation contributes to the limited evidence evaluating the efficacy of child–caregiver interventions in practice. Despite the small sample, the UYT model provides a helpful framework (applicable to clinical contexts) to foster early relationships and emotional development of young children.

Perceptions of Relationships with Kinship Caregivers Among Parents Following State-Detected Psychoactive Substance Use

SYNOPSIS Objective. This study sought to better understand parent relationships with kinship caregivers, with an eye toward parents’ perceptions of how kinship caregiver mindsets and behaviors surrounding substance use may have impacted parents. Design. Data came from transcripts of in-depth, semi-structured interviews with 16 parents in the United States, who had substantiated child welfare cases related to substance use. Transcripts were dual-coded, and analysis was guided by the reflexive thematic analysis framework. Results. Parents described two different experiences with kinship caregivers. For some families, parents reported fragmentation of their support system; parents described caregivers as undermining their parental authority, disrupting attachment bonds, and communicating with children in ways that perpetuated stigma around substance use. Other parents reported increased cohesion among family members; parents described caregivers as supportive and empowering, particularly as they navigated mandated “recovery.” Conclusions. Findings offer insights to help inform decision-making by both practitioners and policymakers by giving a voice to parents as they navigate the complex systems of child welfare services and drug court programming.

Supportive interventions for family caregivers of adults with mental illness: An integrative review

Background: People of all ages, genders, social classes, income levels, and geographical regions can be affected by mental illness. Families of individuals diagnosed with mental illnesses face significant burdens, particularly due to their role as family caregivers. Aim: This integrative review aims to characterize the interventions that support family caregivers to reduce their burden of caregiving. Methodology: Whittemore and Knafl’s methodology guided this integrative literature review. CINAHL, MEDLINE, and PsycINFO were searched for articles published between 2014 and 2023. Eighteen articles were identified as eligible studies to identify supportive interventions. These articles were then critically appraised and relevant data analyzed and synthesized to formulate the results. Findings: The included studies reported interventions focused on family caregivers of relatives with mental illnesses. The two main themes of these studies are (a) interventions to offset the burden of caregiving and (b) outcomes related to these interventions. These interventions include psychoeducation, adaptive cognitive-behavioral strategies, peer support, and religious support. Conclusion: Caring for a mentally ill family member is an extremely stressful situation for family caregivers. Supportive interventions found in this integrative review could help these family caregivers overcome their burdens.

Exploring the experience of family members caring for a relative with alcohol use disorder: A phenomenological inquiry.

Alcohol use disorder (AUD) is a global concern with negative physical, psychological and social consequences. The ramifications of AUD extend beyond the individual and affect their family caregivers. Yet, the majority of existing research has primarily focused on individuals with AUD and interventions to encourage their abstinence rather than on their support systems. In order to advance a holistic approach, research to address this gap is imperative to understand family caregiver concerns and needs for added support. We conducted a qualitative study using van Manen's hermeneutic phenomenological approach to uncover the meaning of family caregivers' lived experiences and capture the essence of their involvement in caring for a relative with AUD. A purposeful and snowball sample of family members (N = 10) living within the United States participated in a face-to-face or virtual, one-on-one audio-recorded interview and a second meeting for member checking the transcribed data. Participants received a $20.00 gift card as a token for their participation. Six major themes emerged from the description of participants' lived experiences: (1) traversing the peaks and valleys, (2) wandering in the unknown, (3) pointing fingers, (4) weathering the storm, (5) drawing a line and (6) looking back, looking in. Although participants experienced many challenges, they never relinquished and remained committed to their caregiver role. Steadfastly staying with their relatives through crises exemplifies commitment as described by Sister Simone Roach's Theory of Caring. Through the ups and downs, each participant found meaning from the experience, which aligned closely with Starck's Theory of Meaning. This study has implications for nursing practice, public health policy and highlights the need for collaboration to address the existing challenges for family caregivers of relatives with AUD.

Aging in place or aging out of place? Family caregivers’ perspectives on care for older Pakistani migrants in Norway

The aging population in Europe is increasing, with growing ethnic diversity among older individuals due to migration. Public policies emphasize ‘aging in place’ to address financial challenges and reduce the burden on the healthcare system. However, research often overlooks the heterogeneity among older people, especially non-European migrants. Also, research on family caregivers’ role in enabling ‘aging in place’ for older relatives with migrant backgrounds is limited, despite many older non-European migrants’ preference for family care in comparison to long-term institutional care. This study aims to explore the experiences and perspectives of family caregivers in the context of formal and informal care and their preferences regarding the place of care for older family members with migrant backgrounds, particularly the Pakistani Ahmadiyya community in Norway. Eighteen semi-structured individual interviews and two group interviews were conducted in Urdu and English with nineteen female family caregivers of older relatives, ages 25–62, residing in Norway. The analysis yielded three main themes: (1) “Nursing homes are not for the ones who love their parents”, (2) Preferences for home with the possibility of sharing care, and (3) Mismatch between family care needs and formal care. Family caregivers’ perception of health services has a decisive impact on their older relatives’ demand and use of formal health services, emphasizing the need for trust. Even though home care services were seen as a viable option, they should be adapted so that the family caregivers can use them and feel supported in enabling ‘aging in place’ for older migrants.