Caregiver Social Support Research Articles

Self-Efficacy Partially Mediates between Social Support and Health-Related Quality of Life in Family Caregivers for Dementia Patients in Shanghai

Background: There is a paucity of research assessing health-related quality of life (HRQoL) and self-efficacy in caregivers of relatives with dementia in mainland China. Aims: To compare the level of HRQoL between caregivers and the general population in mainland China and to assess the role of caregiver self-efficacy in the relationship between caregiver social support and HRQoL. Methods: A cross-sectional study was conducted in Shanghai, China. The caregivers were recruited from the outpatient department of a teaching hospital. A total of 195 participants were interviewed, using a survey package including the Chinese version of the 36-Item Short-Form Health Survey (SF-36), demographic data, the variables associated with the impairments of care recipients, perceived social support and caregiver self-efficacy. The caregivers' SF-36 scores were compared with those of the general population in China. Results: The results indicated that the HRQoL of the caregivers was poorer compared with that of the general population when matched for age and gender. Multiple regression analyses revealed that caregiver self-efficacy is a partial mediator between social support and HRQoL, and a partial mediator between behavioral and psychological symptoms of dementia (BPSD) and caregiver mental health. Conclusion: Assisting with managing BPSD and enhancing caregiver self-efficacy can be considered integral parts of interventions to improve caregiver HRQoL.

Effects of Social Support on Physical Activity, Self-Efficacy, and Quality of Life in Adult Cancer Survivors and Their Caregivers

To explore the relationships between adult cancer survivor and caregiver social support, self-efficacy for physical activity (SEPA), physical activity (PA) behavior, and quality of life (QOL); and to understand cancer survivors' and their caregivers' perceptions of social support in PA participation. Quasi-experimental. Five community-based exercise sites located in East Texas. 101 adult cancer survivors and caregivers. Participants completed questionnaires, the 8-Foot Up-and-Go test, and open-ended questions. Data analysis included descriptive statistics and frequencies, Spearman's rho, Mann-Whitney U, and Wilcoxon signed-rank test. Qualitative data were analyzed using thematic analysis. Social support, SEPA, PA, and QOL. Physical QOL was significantly higher in caregivers than cancer survivors. Spearman's rho identified a negative relationship between physical QOL and PA in cancer survivors; and a significant relationship between PA and PA participation in caregivers with social support from friend. Three themes emerged from the qualitative data regarding the perception of social support: companionship, motivation, and health promotion. Caregivers have higher QOL despite being the major social support provider to cancer survivors. Social support is essential to PA participation. Interventions to increase PA in adult cancer survivors may consider encouraging their caregivers to actively participate. Caregivers play an important role in the PA of cancer survivors. Perceived social support in the form of companionship and motivation may increase PA in cancer survivors and caregivers. Therefore, nurses may consider educating cancer survivors and caregivers on the importance of adopting and maintaining PA throughout the cancer care continuum.

Attachment style, social support and finding meaning among spouses of colorectal cancer patients: Gender differences

The current study explores the relationship between attachment styles, social support, gender and finding meaning in caregiving among spousal caregivers of colorectal cancer patients. Sixty caregivers (30 men and 30 women) were administered questionnaires assessing attachment styles, social support and finding meaning in caregiving, using a cross-sectional design. For male caregivers avoidance attachment is associated with their finding meaning, whereas for female caregivers social support is associated with their finding meaning. Psychological interventions for caregivers should take into consideration gender differences and might benefit from addressing the process of finding meaning in caregiving.

Differences Between Dementia Caregivers Who are Users and Nonusers of Community Services

To examine differences between users and non-users of community services in caregivers of persons with dementia (PWD). A profile of who used services versus did not use services was developed. Existing cross-sectional data from the NINR funded National Caregiver Training Project (data collected 1995-1997) were used. The sample (N = 241) of caucasian, well-educated caregivers reflected a mix of spouse and adult caregivers with a mean age of 64.8 years. Variables measured included caregiver social support, burden, and depression as well as problem behavior of PWD. The majority of caregivers did not attend support groups (73%) or use respite services (79%). Among caregivers who did not use services, 78% lived with the recipient and 77% were spouses. The profile of non-users compared to users revealed that non-users were significantly older, more depressed, and received less social support. On the other hand, non-users provided fewer hours of care per week to recipients who had less cognitive and functional deterioration and fewer behavior problems. These findings provide public health nurses with knowledge about service use in caregivers of PWD. Recommendations regarding caregiver needs for assistance and increased use of services before a crisis ensues are presented.

Exploring Spirituality in Family Caregivers of Patients With Primary Malignant Brain Tumors Across the Disease Trajectory

To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory. Ongoing descriptive, longitudinal study. Southwestern Pennsylvania. 50 family caregivers of patients with PMBT. Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subsequent time points, four and eight months following diagnosis. Care recipients' symptoms, neuropsychologic status, and physical function, as well as caregiver social support. Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory. Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality. Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support. Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress.

The relationship between social support and the health of HIV-positive caregivers of children: A review of the empirical literature

A wealth of global literature suggests that social support can play an important protective role for the well-being of caregivers of children and the children in their care. In Southern Africa, where the caregiving burden is intensifying and the prevalence of HIV and other physical and mental health disorders is elevated, strengthening social support resources may be the key to more effective carer and child health interventions. This may be especially true for HIV-positive and/or AIDS-ill carers, who face heightened caregiving challenges and health risks. This review aims to consolidate the existing international literature in this area by summarizing methodologies and empirical findings of published and unpublished studies that quantitatively assess the association between one or more measurable dimension of social support and one or more measurable physical or mental health outcome, among HIV-positive and/or AIDS-ill adult caregivers of children. Limitations, strengths and key findings of the 15 identified studies are discussed, as are gaps and implications for future research. Overall, study findings highlight a positive relationship between social support and health, particularly mental health, reinforcing the importance of social support as an integral element of mental health interventions for HIV-positive caregivers of children. The absence of research in Southern Africa, and other parts of the developing world most affected by the HIV/AIDS epidemic, highlights the need for future investigation in these contexts. Recommendations for further research include larger and more representative studies; longitudinal studies; studies with caregivers of non-biological children; and research linking caregiver social support to parenting and child outcomes. Moreover, mixed methodology approaches would be useful to better understand the sources and types of social support most relevant for health outcomes in this specific population, as well as the mechanisms through which this support may be affecting health.

The relationship between anticipated needs and social support in caregivers of stroke survivors

Objective To explore the relationship between anticipated needs and social support of family caregivers of stroke survivors after discharge.Methods Modified Caregiver Assessment Scale (MCAS) and Social Support Inventory (SSI) were used to measure the levels of anticipated needs and social support of family caregivers of stroke survivors after discharge.SPSS 16.0 was used to analyze the data.Results The mean score of MCAS of caregivers of stroke survivors was 0.97 ± 0.56.Three items ranked among the most important needs after discharge were lack of information about stroke prevention',lack of information about health and social services',lack of help in social service',The mean score of Social Support Inventory was 1.15 ～3.26.The highest score was in the domain of emotional support (2.99 ±0.61 ),and the lowest was information support ( 1.32 ± 0.41 ).Conclusions Anticipated needs is negatively correlated with social support among family caregivers of stroke survivors.Those with a higher level of social support will have less needs. Key words: Stroke; Primary caregiver; Need; Social support

Identifying family members who are likely to perceive benefits from providing care to a person with a primary malignant brain tumor.

To identify changes in positive aspects of care (PAC) from the time of diagnosis to four months following the diagnosis in family caregivers of care recipients with primary malignant brain tumors. Longitudinal. Dyads were recruited from neurosurgery clinics in Pittsburgh, PA, at the time of care recipients' diagnosis with a primary malignant brain tumor. A second data collection took place four months following the diagnosis. 89 caregiver and care recipient dyads. Paired t tests were used to examine change in PAC, univariate analyses were used to determine predictors of PAC at four months, Mann-Whitney U tests and t tests were used to examine associations between categorical predictor variables and PAC at four months, and univariate linear regressions were used to examine associations between continuous predictors and PAC at four months. The impact of sociodemographic factors, caregiver-perceived social support, mastery, neuroticism, and marital satisfaction on PAC. Caregivers' PAC scores during the first four months following diagnosis appeared to remain stable over time. Significant differences were found between the care recipient reasoning domain group at diagnosis and PAC score. Care recipients who scored below average were associated with caregivers with higher PAC scores. Caregiver PAC at four months following diagnosis was significantly predicted by care recipient reasoning and caregiver social support. PAC scores appear to remain stable over time, although levels of PAC may be related to care recipients' level of functioning. Future research should focus on the development of interventions for caregivers who report low levels of PAC at the time of diagnosis in an attempt to help these individuals identify PAC in their caregiving situation. Findings have clinical and research implications. Clinicians may be able to better identify caregivers who are at risk for negative outcomes by understanding the risks faced by caregivers of patients with milder symptoms in addition to those caring for more profoundly affected care recipients.

Predicting resilience in sexually abused adolescents

This research examined factors that predicted resilience in sexually abused adolescents. Using Bronfenbrenner's Process-Person-Context-Time (PPCT) ecological model, this study considered the proximal and distal factors that would contribute to adolescents’ reactions to sexual victimization. This correlational study used hierarchical regression analysis (n=237) with cross-sectional data from the National Survey of Child and Adolescent Well-Being Wave I (NSCAW, Dowd et al., 2002). This study found that school engagement, caregiver social support, hope and expectancy, caregiver education and SES predicted resilience. In line with the PPCT model, findings suggest that placing a greater emphasis on the contextual environment could improve support for adolescent resilience. Augmenting interventions that focus on individual change with those that address environmental factors may increase the benefits to adolescents affected by sexual abuse.

Strain and satisfaction in caregivers of veterans with chronic illness

Veterans' health care has shifted towards outpatient treatment, and because of the high prevalence of chronic illness in veterans, more caregiving has been required of their families. The purpose of this study was to identify predictors of caregiver (CG) strain and satisfaction associated with caring for veterans with chronic illness. Data were collected using telephone interviews of 120 dyads. Strain was associated with helping with instrumental activities of daily living, using counseling and prayer for coping, accompanying veteran to appointments, help/advice from friends, paid help, exercising, and depression. Satisfaction was associated with veteran health, CG social support, age, and depression. Innovative and easily accessible interventions are needed to mitigate sources of strain in CGs of chronically ill veterans.

Caregiver Social Support for Children Involved With Child Welfare: Correlates and Racial/Ethnic Variations

This study examined correlates of and racial/ethnic variations in social support for caregivers involved in child protective services. A subsample of caregivers and children from the National Survey of Child and Adolescent Well-Being (NSCAW) was used to examine whether sources and amount of social support for parents in child welfare would vary by race and ethnicity. The findings indicate that caregivers of maltreated children suffer from a lack of support, specifically confidant, affective, and instrumental social support. This study also found that African American caregivers have higher levels of affective social support than do non-Hispanic Whites (NHWs), controlling for other significant caregiver and child characteristics. Structural measures including age, gender, and family income also explained variations in caregiver social support. Research and practical implications are discussed.

Longitudinal Functional Recovery After Postacute Rehabilitation in Older Hip Fracture Patients: The Role of Cognitive Impairment and Implications for Long-Term Care

To compare functional recovery patterns of cognitively impaired and nonimpaired older adults who had hip fracture surgeries, and to identify associated long-term care needs. Longitudinal study (n = 231). Data were collected within 72 hours of admission to and before discharge from the postacute rehabilitation facilities and at 2, 6, and 12 months following postacute rehabilitation discharge. Six functional independence measures (FIM) were used to assess functional recovery. Mini-mental status examination was used to gauge cognitive function. Mixed-effects analyses quantify differences of FIM functional recovery patterns between groups while adjusting for potential confounders. Multivariate results showed that patients with impaired cognition had notably different functional recovery patterns and significantly worse overall FIM scores (P < .001) than their counterparts in all 6 FIM functions.For locomotion function at 1 year, cognitively nonimpaired patients needed little supervision (mean FIM = 5.6), whereas patients with impaired cognition needed 50% human assistance (FIM = 3.9). In addition to needing locomotion assistance, cognitively impaired patients also required 25% human assistance in transfers (FIM = 4.8), 25% in self-care (FIM mean = 5.3), and 25% in sphincter control (FIM mean = 5.0). Cognitively impaired patients experienced recovery at 2 and 6 months but were unable to retain rehabilitation gains in locomotion, transfers, self-care, and sphincter control at 1 year following postacute rehabilitation discharge, and they still required human assistance to stay in their homes within the community. To prevent or delay nursing home entry, it is suggested that appropriate long-term care planning and social support for caregivers are needed for cognitively impaired hip fracture patients.

Individual- and Family-Level Psychosocial Correlates of HIV Risk Behavior Among Youth in Rural Kenya

Associations between individual- and family-level psychosocial factors and sexual behavior were examined among 325 adolescents ages 10-18 in rural Kenya. History of sexual activity was reported by 51% of males and 30% of females. Among those reporting sex within the past year, 64% of males and 32% of females had multiple partners; 85% of males and 54% of females reported not using a condom at last sex. Multivariate logistic regression modeling demonstrated sexually active adolescents were significantly more likely to be older, male, more accepting of risky behavior, and have greater perceived HIV risk, caregiver social support, social support related to HIV, and emotional problems. Youths reporting high-risk behavior (unprotected sex or multiple partners) were significantly more likely to be younger, male, and have lower sex-related self-efficacy, lower caregiver monitoring, and more externalizing problems. Future studies should evaluate HIV prevention interventions targeting improvements in mental health and family relationships.

The Schizophrenia Care Management Program for Family Caregivers of Chinese Patients With Schizophrenia

This study tested the effectiveness of a schizophrenia care management program for family caregivers of Chinese patients with schizophrenia in Hong Kong. A multisite controlled trial was conducted with 92 patient-caregiver dyads. They were randomly assigned to either the schizophrenia care management program or to usual care. The patients' symptoms, functioning, and length of rehospitalization and their families' perceived social support, expressed emotion, and functioning were measured at recruitment and at one month and 15 months after the intervention. Compared with families in the usual care group, families in the schizophrenia care management program reported significantly greater improvements in families' and patients' functioning and caregivers' perceived social support and decreases in the number and length of patients' rehospitalization. The findings provide evidence that the multidisciplinary schizophrenia care program can improve the psychosocial functioning of patients and their families and social support of caregivers.

Social support buffers the impact of functional impairments on caregiver psychological well‐being in the context of brain tumor and other cancers

This study investigated the association between functional impairments of individuals with cancer and caregiver psychological well-being, and examined the moderating effect of social support. Sixty-three caregivers (71% female) of individuals with brain tumor (n=27) and other cancers (n=36) were recruited from community services. Caregivers rated their psychological well-being on the World Health Organisation Quality of Life measure Brief version, social support on a brief version of the Social Support Questionnaire, and the individuals' functional impairments on the Patient Competency Rating Scale. For caregivers of individuals with brain tumor, better psychological well-being was associated with lower functional impairment in all domains (r(s)=0.33-38, p<0.05), except for cognitive difficulties. For caregivers of individuals with other cancers, better psychological well-being was associated with lower functional impairment in all domains (r(s)=0.30-0.49, p<0.05), with the exception of activities of daily living. For the total caregiver sample, better psychological well-being was significantly correlated with overall functional impairment (r=0.34, p<0.005) and satisfaction with support (r=0.40, p<0.005). Caregivers supporting individuals with greater functional impairment had better psychological well-being if they were highly satisfied with their social support. Effective social support is particularly important for caregivers who support individuals with poorer functional status, and this study highlights the need to evaluate caregiver social support interventions in the context of cancer.

Needs of Older Caregivers of Patients with Advanced Cancer

To determine whether age or stage of cancer can be used to identify caregivers at high risk for excessive burden or distress. Descriptive data collected as part of a psychosocial research registry, comparing younger caregivers with older and caregivers of early-stage patients with those of later stage. Caregivers of newly diagnosed adult cancer patients. Caregiver Reaction Assessment (CRA), the Profile of Mood States (POMS), single-item indicators from the Patient Reported Outcome Measurement Information System set, and the Medical Outcomes Study Social Support (MOS-SS) Scale. Patient information was obtained from the medical record. Younger caregivers and caregivers of patients with Stage I and II cancer identified a greater lack of family support than older caregivers and caregivers of patients with Stage III and IV cancer. Significant regression models were found for three CRA subscales (Disrupted Schedule, Lack of Family Support, and Health Problems), as well as for the POMS depression and fatigue scales. Caregiver social support (MOS-SS) made the only significant contribution to the models. There were significant differences between caregivers with high and low levels of social support on almost all measures of well-being. Incorporating formal assessment of social support may be useful in identifying at-risk caregivers. In addition, there is a need to further investigate which dimensions of social support are most strongly related to measures of well-being.

3063 The impact of cancer diagnosis and treatment to the caregivers' social capital and social support

3063 The impact of cancer diagnosis and treatment to the caregivers' social capital and social support

Leisure and distress in caregivers for elderly patients

Caregiving for the elderly has been linked to mental and physical problems in those providing the care. The aim of this study is to analyze the effects of leisure on caregiver's burden and mental health. Drawing on the stress and coping model, 134 caregiver/care-recipient dyads were assessed. In addition to caregivers’ perception of their leisure time, social support, burden and mental health, care-recipients’ functional and mental status were also measured. The results of a set of hierarchical regression analyses showed that caregivers’ perceptions of their leisure time were significantly negatively related to burden and mental health problems ( p < 0.01), even after socio-demographic variables, care recipient's functional status and caregiver's social support had been controlled. The results of this study suggest that leisure time has a significant impact on caregiver's psychological well-being, and appears to be an important issue for buffering caregiver distress.

Study on the care burden level and social support of Mild patient's main watchers

Objective To investigate the level of burden and social support and their correlation of main watcher of MHD patients.Methods Sixty-two patient caregivers were investigated with caregivers' burden scale and Social Support Rating Scale(SSRS),.The results were statistically analysed.Results (1)Main caregivers' burden level was high,the mean score of the total burden was(54.71±20.322).Among the three dimensions of the care burden,the score of social function burden was little higher than psychological function,the score of physical function was the lowest .(2)Main caregivers of MHD patients had lower social support level comparing with the normal people;And the total score is(31.44±9.623);Among the three dimensions of the social support,the score of subjective support is highest,the score of social support utilization was in the centre,and the score of objective support was the lowest.(3)Main caregivers' of MHD patients care burden level was found negatively correlated with their social support(P ＜0.01);Social function burden,psychological function burden,physical function burden were found significantly negatively correlated with subjective support (P ＜0.01);Social function burden was also found significantly negatively correlated with social support utilization(P ＜0.05).Conclusions Main caregivers of MHD patients should attracted wide attention from society,relative medical institution should take effective measures to raise the level of their social support and decrease their burden.. Key words: MHD patients; Main watcher; Burden; Social support

Adherence to disease-modifying therapies in multiple sclerosis: Does caregiver social support matter?

Adherence to disease-modifying therapies in multiple sclerosis: Does caregiver social support matter?