Sociodemographic Characteristics Of Caregivers Research Articles

Impact of the COVID-19 pandemic on perceived changes in responsibilities for adult caregivers who support children and youth in Ontario, Canada.

The COVID-19 pandemic has created long-lasting changes in caregiving responsibilities, including but not limited to increased demands, loss of support, worsening mental and physical health, and increased financial worries. There is currently limited evidence regarding factors associated with perceived changes in caregiving responsibilities. This observational study aimed to investigate factors (sociodemographic characteristics of caregivers and mental health and/or addiction concerns of the caregiver and their youth) that predict perceived negative changes in caregiving responsibilities among adult caregivers (aged 18+ years) of children and youth (aged 0-25 years) in Ontario, Canada, during the COVID-19 pandemic. Data were collected from 1381 caregivers of children and youth between January and March of 2022 through a representative cross-sectional survey completed online. Logistic regression was conducted to determine predictors contributing to perceived negative changes in caregiving responsibilities. Among the sociodemographic characteristics, only ethnicity significantly predicted outcome. Higher caregiver strain (odds ratio [OR] = 10.567, 95% CI = 6.614-16.882, P < 0.001), worsened personal mental health (OR = 1.945, 95% CI = 1.474-2.567, P < 0.001), a greater number of children/youth cared for per caregiver (OR = 1.368, 95% CI = 1.180-1.587, P < 0.001), dissatisfaction with the availability of social supports (OR = 1.768, 95% CI = 1.297-2.409, P < 0.001) and negative changes in mental well-being in at least one child/youth (OR = 2.277, 95% CI = 1.660-3.123, P < 0.001) predicted negative changes in caregiving responsibilities. These results support further exploration of the implications of negative perceptions of caregiving responsibilities and what processes might be implemented to improve these perceptions and the outcomes.

Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood

Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9–15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = −0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. Trial registrationNational Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.

Coping Behaviors and Health Status during the COVID-19 Pandemic among Caregivers of Assisted Living Residents in Western Canada.

To examine the prevalence of coping behaviors during the first 2 waves of the COVID-19 pandemic among caregivers of assisted living residents and variation in these behaviors by caregiver gender and mental health. Cross-sectional and longitudinal survey. Family/friend caregivers of assisted living residents in Alberta and British Columbia. A web-based survey, conducted twice (October 28, 2020 to March 31, 2021 and July 12, 2021 to September 7, 2021) on the same cohort obtained data on caregiver sociodemographic characteristics, anxiety and depressive symptoms, and coping behaviors [seeking counselling, starting a psychotropic drug (sedative, anxiolytic, antidepressant), starting or increasing alcohol, tobacco and/or cannabis consumption] during pandemic waves 1 and 2. Descriptive analyses and multivariable (modified) Poisson regression models identified caregiver correlates of each coping behavior. Among the 673 caregivers surveyed at baseline, most were women (77%), White (90%) and age ≥55years (81%). Alcohol (16.5%) and psychotropic drug (13.3%) use were the most prevalent coping behaviors reported during the initial wave, followed by smoking and/or cannabis use (8.0%), and counseling (7.4%). Among the longitudinal sample (n= 386), only alcohol use showed a significantly lower prevalence during the second wave (11.7% vs 15.1%, P = .02). During both waves, coping behaviors did not vary significantly by gender, however, psychotropic drug and substance use were significantly more prevalent among caregivers with baseline anxiety and depressive symptoms, including in models adjusted for confounders [eg, anxiety: adjusted risk ratio= 3.87 (95% CI 2.50-6.00] for psychotropic use, 1.87 (1.28-2.73) for alcohol use, 2.21 (1.26-3.88) for smoking/cannabis use). Assisted living caregivers experiencing anxiety or depressive symptoms during the pandemic were more likely to engage in drug and substance use, potentially maladaptive responses. Public health and assisted living home initiatives that identify caregiver mental health needs and provide targeted support during crises are required to mitigate declines in their health.

Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia.

Dementia is currently one of the major causes of disability and dependency among older adults worldwide. Cognitive dysfunction, neuropsychiatric symptoms, somatic complaints, and functional impairment fundamentally affect not only a person living with dementia (PLwD), but also his/her informal caregiver(s), often resulting in a high caregiver burden. A number of variables, including the caregiver's sociodemographic characteristics, the clinical characteristics of PLwD, social support, and the caregiver's personal resources determine the caregiver's burden. The aim of this study was to investigate the associations of caregiver burden in informal caregivers of PLwD with perceived social support, positive caregiving experience, and applying therapeutic communication methods. The data were collected from September 2021 to February 2022 among 115 "PLwD-informal caregiver" dyads in the community settings in Slovakia. Measures included the Zarit Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3), the Positive Aspects of Caregiving Scale (PACS), and two questions on applying therapeutic communication methods-reminiscence and validation according to Naomi Feil. The Short IQCODE was used for assessing cognitive decline in PLwD. Pearson's and Spearman's correlations, t-tests, Chi-square, ANOVA, and linear multiple regression analyses were used to analyze the data (IBM SPSS 27). The mean age of informal caregivers was 54 ± 12.4 years (81.7% of women) and the mean caregiving duration was 4.8 ± 4.8 years. The mean age of PLwD was 80.5 ± 8.3 years (73.0% of women) and their Short IQCODE mean score was 4.1 ± 1.0. Lower caregiving burden was significantly associated with higher perceived social support (β = 0.33, p < 0.01), with higher positive caregiving experience (β = 0.33, p < 0.01), and higher caregiving intensity (β = 0.24, p < 0.05) among informal caregivers of PLwD. The associations between caregiver burden and applying two therapeutic communication methods were not significant. Implementing psycho-social and educational public health interventions focused on strengthening social support and maintaining positive perceptions of caregiving can help reduce the increased risk of caregiver burden in informal caregivers of older adults with dementia.

Coverage and Equity of Childhood Vaccines in China

Measuring vaccination coverage rates and equity is crucial for informing immunization policies in China. To estimate coverage rates and multidimensional equity for childhood vaccination in China. This cross-sectional study was conducted via a survey in 10 Chinese provinces between August 5 and October 16, 2019, among children ages 6 months to 5 years and their primary caregivers. Children's vaccination records and their primary caregivers' demographics and socioeconomic status were collected. Data were analyzed from November 2019 to March 2022. Vaccine coverage rates were measured as a percentage of National Immunization Program (NIP) and non-NIP vaccines administered before the day on which the child was surveyed. A multidimensional equity model applied a standardized approach to ranking individuals from least to most unfairly disadvantaged by estimating differences between observed vaccination status and estimated vaccination status as function of fair and unfair variation. Fair sources of variation in coverage included whether the child was of age to receive the vaccine, and unfair sources of variation included sex of the child and sociodemographic characteristics of caregivers. Absolute equity gaps (AEGs), concentration index values, and decompositions of factors associated with vaccine equity were estimated in the model. Vaccine records and sociodemographic information of 5294 children (2976 [52.8%] boys and 2498 [47.2%] girls; age range, 6-59 months; 1547 children aged 12-23 months) and their primary caregivers were collected from 10 provinces. Fully immunized coverage under the NIP was 83.1% (95% CI, 82.0%-84.1%) at the national level and more than 80% in 7 provinces (province coverage ranged from 77.8% [95% CI, 74.3% to 81.3%] in Jiangxi to 88.4% [95% CI, 85.7%-91.1%] in Beijing). For most non-NIP vaccines, however, coverage rates were less than 50%, ranging from 1.8% (95% CI, 1.3%-2.2%) for the third dose of rotavirus vaccine to 67.1% (65.4% to 68.8%) for the first dose of the varicella vaccine. The first dose of Haemophilus influenzae type b vaccine had the largest AEG, at 0.603 (95% CI, 0.570-0.636), and rotavirus vaccine dose 3 had the largest concentration index value, at 0.769 (95% CI, 0.709-0.829). The largest share of non-NIP vaccine inequity was contributed by monthly family income per capita, followed by education level, place of residence, and province for caregivers. For example, the proportion of explained inequity for pneumococcal conjugate vaccine dose 3 was 40.94% (95% CI, 39.49%-42.39%), 22.67% (95% CI, 21.43%-23.9%), 27.15% (95% CI, 25.84%-28.46%), and 0.68% (95% CI, 0.44%-0.92%) for these factors, respectively. This cross-sectional study found that NIP vaccination coverage in China was high but there was inequity for non-NIP vaccines. These findings suggest that improvements in equitable coverage of non-NIP vaccination may be urgently needed to meet national immunization goals.

Caregiving-Related Work Productivity Loss Among Employed Family and Other Unpaid Caregivers of Older Adults

ObjectivesAlthough nearly half of all family and unpaid caregivers to older adults work, little is known about short-term work impacts of caregiving using measures encompassing both missed work time and reduced productivity while physically at work. We quantify the prevalence, costs, and correlates of caregiving-related work productivity loss. MethodsWe used the 2015 National Study of Caregiving and National Health and Aging Trends Study to estimate caregiving-related work absences (absenteeism) and reduced productivity while at work (presenteeism). We calculated costs of lost productivity using hours lost, compensation, and a wage multiplier, accounting for the additional cost of replacing employee time. We examined correlates of caregiving-related absenteeism and presenteeism separately, using multivariable logistic regression models, adjusting for caregiver sociodemographic characteristics, occupation and hours worked, role overload, older adult health, use of respite care, support groups, flexible workplace schedules, help from family or friends, and caregiver training. ResultsNearly 1 in 4 (23.3%) of the estimated 8.8 million employed family caregivers reported either absenteeism or presenteeism over a 1-month period owing to caregiving. Among those affected, caregiving reduced work productivity by one-third on average—or an estimated $5600 per employee when annualized across all employed caregivers—primarily because of reduced performance while present at work. Productivity loss was higher among caregivers of older adults with significant care needs and varied according to sociodemographic characteristics and caregiver supports. ConclusionsFindings emphasize the potential economic value of targeted policy intervention to support working caregivers.

Dietary Diversity Among U.S. Infants and Toddlers: Associations With Caregiver Sociodemographic Characteristics

ObjectivesThe introduction to a variety of foods during the first two years of life is recommended to ensure adequate intake of essential nutrients required for optimal growth and development. The purpose of this study was to assess dietary diversity among children 4–26 months and to identify associations between caregiver sociodemographic characteristics and child dietary diversity.MethodsCaregivers, recruited via Qualtrics panels, reported on how often foods (n = 57) were offered to their child in the prior month using a food frequency questionnaire designed to assess usual intakes of infant/toddler foods. Foods were grouped (vegetables, fruits, grains, meat and meat alternatives, snacks, sweets, and dairy) and summed into a 7-point dietary diversity score (DDS). Tertiles of dietary diversity were used to classify children by age into low, average, and high diversity. Ordinal logistic regression tested the association between caregiver sociodemographic factors (age, race/ethnicity, household income, partner status, household size) and tertile of child DDS.ResultsCaregivers (n = 344; 70.3% female; M ± SD age 31.5 ± 6.3 y), identified as White (73%), and had attended at least some college (74%). The average DDS for the sample was 4.2 ± 2.35. Among infants (< 12 months; n = 150), 50.8% received breastmilk, 39% consumed 0–2 food groups and 42.0% consumed ≥ 5 food groups (DDS 3.6 ± 2.5). Among toddlers (>12 months; n = 194), 24.8% received breastmilk, 18% consumed 0–2 food groups and 62% consumed ≥ 5 food groups (DDS 4.7 ± 2.1). A Pearson's Chi-Squared test revealed a significant association between breastfeeding status and DDS (c 2 (2) = 8.272, P < 0.05). 23% of children who were receiving breastmilk were classified as low DDS compared with 35% of children not receiving breastmilk. Children from households with ≥ 5 members had 2.7 (95% CI, 1.44 to 4.95) times the odds of high DDS than children from households with ≤ 2 members (P < 0.01). No other caregiver sociodemographic factors were significantly associated with child DDS.ConclusionsCaregiver sociodemographic factors, other than household size, were not related to children's DDS. Given the importance of dietary variety on nutrition adequacy, future work should consider other factors that might influence DDS among infants and toddlers.Funding SourcesThis project was unfunded.

Depression, anxiety, stress levels, and coping styles of caregivers of patients with left ventricular assist device.

To determine the depression, anxiety, stress (DAS) levels, and coping styles of caregivers of patients with left ventricular assist device (LVAD). The sample of the study consisted of 74 caregivers of patients with LVAD. Data were collected using Individual Data Form, DASS 21, and Coping Styles Scale. Depression was found in 67.6%, anxiety in 45.9%, and stress in 50% of the caregivers of patients with LVAD. A significant relationship was found between the sociodemographic characteristics of caregivers, some variables related to the patient and the care process, and coping styles with stress, and DAS levels of caregivers. Considering the variables that may affect the DAS levels of the LVAD caregivers will improve the expected results from the LVAD.

Family Caregiver Burden of Elderly with Dementia : A Literature Review

Background: The majority of the elderly with dementia living in a community have received care from family caregivers with curious complexity of problems to be identified during the care at home. Objective: To identify the level of burden and characteristics that affect the burden on family caregivers who care for the elderly with dementia. Method: A literature reviewwith a search for relevant articles was published between 2015-2020 using the four databases PubMed, Google Scholar, DOAJ,and Oxford Academic Journals. The selection protocol used the PRISMA flow diagram by setting inclusion and exclusion criteria with the PEOS framework about family caregiver burden caring for elderly with dementia. Results: Nineteen articles that met the inclusion criteria and were identified in this literature review were found from Asia, Europe, the U.S , and Brazil. Most family caregivers were identified as having a moderate level of caregiving burden that depends on various factors including characteristics of elderly with dementia, sociodemographic characteristics of caregivers, and characteristics of care itself. The presence of behavior problems, neuropsychiatric symptoms and dependence on daily care in elderly with dementia are the main characteristics that predict the burden. Conclusions: The existence of burden during care that tends to increase on family caregivers, makes it necessary to develop a good strategy to minimize the burden in the future by considering the involvement of health professionals in providing appropriate assistance and services.

Burden and psychological symptoms among caregivers of patients with solid tumor cancers.

To evaluate factors associated with burden reported by caregivers of people undergoing treatment for solid tumor cancers. A secondary analysis of baseline data collected in a cancer symptom management trial was conducted guided by the Organizing Framework for Caregiver Interventions. A total of 349 caregivers completed the Caregiver Reaction Assessment Tool evaluating caregiver burden; Bayliss Comorbidity Tool; and PROMIS-29 version1.0-Anxiety and Depression Short Forms. Multivariable linear models were used to examine the associations of Caregiver Reaction Assessment Tool subscales (caregiver self-esteem, family support, financial, schedule, and health burden) with caregiver sociodemographic characteristics, comorbidities, anxiety, and depression. The majority of caregivers were female and spouses/partners who resided with the patient. Being female, Asian, a spouse of the patient, employed, and having a higher level of anxiety and depressive symptoms were significantly associated with lower caregiver self-esteem, and higher perceived schedule and health burden. Caregiver anxiety and depressive symptoms were also significantly associated with lack of family support and higher financial burden. Clinicians should consider factors that contribute to higher perceived burden for caregivers when they are engaged in home-based supportive care for patients undergoing cancer treatment.

Pediatric non-urgent emergency department visits and prior care-seeking at primary care

BackgroundWe aimed to examine how caregiver perceptions of primary care affects care-seeking prior to pediatric non-urgent ED visits.MethodsWe performed a cross-sectional survey of caregivers of children presenting to a pediatric ED during weekday business hours and triaged as low acuity. We first compared caregiver sociodemographic characteristics, perceptions of primary care, and stated preference in care sites (ED vs PCP) for caregivers who had sought care from their child’s PCP office versus had not sought care from their child’s PCP office prior to their ED visit. We then examined odds of having sought care from their PCP office prior to their ED visit using multivariable logistic regression models sequentially including caregiver primary care perceptions and stated care site preferences along with caregiver sociodemographic characteristics.ResultsOf 140 respondents, 64 (46%) sought care from their child’s PCP office prior to presenting to the ED. In unadjusted analysis, children insured by Medicaid or CHIP, caregivers identifying as Black, and caregivers with lower educational attainment were less likely to have sought PCP care before presenting to the ED (p < 0.005, each). Caregivers who had sought PCP care were more likely to prefer their PCP relative to the ED in terms of ease of travel, cost, and wait times (p < 0.001, all). When including these stated preferences in a multivariable model, child insurance, caregiver race, and caregiver education were no longer significantly associated with odds of having sought PCP care prior to their ED visit.ConclusionsDifferential access to primary care may underlie observed demographic differences in non-urgent pediatric ED utilization.

Disclosure of human immune deficiency virus status to infected children at a tertiary hospital in North-western Nigeria

Background: With the advent of highly active anti-retroviral therapy, human immunodeficiency virus (HIV)-infected children are surviving into adolescence and adulthood. Disclosure of HIV-positive status is important for the life-long management of HIV. However, disclosing HIV-positive status is a challenging task due to the associated blame, shame, and potential stigma. Aim: The aim of this study is to assess the prevalence of disclosure to HIV-infected children and associated factors in a tertiary hospital in North-west Nigeria. Materials and Methods: A descriptive, cross-sectional study was carried out. Fifty-two parents/caregivers were interviewed using a pretested interviewer-administered questionnaire. The questionnaire had three sections: sociodemographic characteristics of caregivers, child's profile, and determinants of disclosure of HIV status. Data were collected and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21, and results were presented using the tables. The Chi-square test was used to test for the association. Fisher's exact test was used where conditions for the Chi-square test were not met. P < 0.05 was statistically significant. Results: The prevalence of disclosure of HIV-positive status to HIV-infected children was 32.7%. Children's age (P = 0.003) and their level of education (P = <0.001) had significant associations with the disclosure. The most common (9, 52.9%) reason given for disclosure was persistent questioning of caregivers about reasons for taking medication despite not being ill. Conclusion: The prevalence of HIV status disclosure to HIV-positive children was low in this study. Health-care workers can provide support to encourage and better prepare parents/caregivers for the process of disclosure.

The Influence of Intrinsic Motivation on Pay Satisfaction Among Caregivers in Residential Home for the Elderly in China: The Mediating Role of Job Burnout.

ABSTRACTBackgroundAccording to the theory of compensating differentials, caregivers with high levels of intrinsic motivation should exhibit a higher-than-average satisfaction with their pay. Whereas studies conducted in Western countries have provided empirical evidence for the theory of compensating differentials in various care settings, few studies have been conducted in China that focus on caregivers employed in residential homes for the elderly (RHE). The sociodemographic characteristics of caregivers in China different significantly from their counterparts in Western countries.PurposeThis study was developed to analyze the mediating role of job burnout to assess the influence of intrinsic motivation on pay satisfaction among caregivers in RHE.MethodsStructural equation modeling was used to examine the influences of intrinsic motivation on pay satisfaction in a sample of 1,212 caregivers employed in RHE in China by analyzing the mediating role of job burnout.ResultsIntrinsic motivation was found to relate positively to pay satisfaction (β = .11, p < .05). Negative relationships were identified between intrinsic motivation and job burnout (β = −.46, p < .01) and between job burnout and pay satisfaction (β = −.13, p < .01). Job burnout was found to have a significant mediating effect on the relationship between intrinsic motivation and pay satisfaction (β = .06, p < .01).Conclusions/Implications for PracticeA significant relationship was found between intrinsic motivation and pay satisfaction, with job burnout playing a mediating role in caregivers employed in RHE in China. This research has profound implications for nursing education, practice, and research. First, greater efforts should be focused on instilling nursing values in nursing students to foster intrinsic motivation. Second, nonpecuniary rewards may be offered to caregivers to acknowledge the values of care work and strengthen intrinsic motivation. Third, a supportive working climate should be fostered to reduce job burnout. Fourth, caregivers should be informed of their rights to decent pay and their right to bargain collectively through unions. Fifth, appropriate public policies should be implemented to provide pay for caregivers at levels that recognize and appreciate their intrinsic motivation.

Quality of life among caregivers of people with end-stage kidney disease managed with dialysis or comprehensive conservative care

BackgroundTo measure health-related and care-related quality of life among informal caregivers of older people with end-stage kidney disease (ESKD), and to determine the association between caregiver quality of life and care recipient’s treatment type.MethodsA prospective cross-sectional study was conducted. Three renal units in the UK and Australia were included. Informal caregivers of people aged ≥75 years with ESKD managed with dialysis or comprehensive conservative non-dialytic care (estimated glomerular filtration (eGFR) ≤10 mL/min/1.73m2) participated. Health-related quality of life (HRQoL) was assessed using Short-Form six dimensions (SF-6D, 0–1 scale) and care-related quality of life was assessed using the Carer Experience Scale (CES, 0–100 scale). Linear regression assessed associations between care-recipient treatment type, caregiver characteristics and the SF-6D utility index and CES scores.ResultsOf 63 caregivers, 49 (78%) were from Australia, 26 (41%) cared for an older person managed with dialysis, and 37 (59%) cared for an older person managed with comprehensive conservative care. Overall, 73% were females, and the median age of the entire cohort was 76 years [IQR 68–81]. When adjusted for caregiver sociodemographic characteristics, caregivers reported significantly worse carer experience (CES score 15.73, 95% CI 5.78 to 25.68) for those managing an older person on dialysis compared with conservative care. However, no significant difference observed for carer HRQoL (SF-6D utility index − 0.08, 95% CI − 0.18 to 0.01) for those managing an older person on dialysis compared with conservative care.ConclusionsOur data suggest informal caregivers of older people on dialysis have significantly worse care-related quality of life (and therefore greater need for support) than those managed with comprehensive conservative care. It is important to consider the impact on caregivers’ quality of life when considering treatment choices for their care recipients.

Family Caregivers’ Experiences With Health Care Workers in the Care of Older Adults With Activity Limitations

Family and unpaid caregivers often play an active role in managing the care of older adults with activity limitations. To examine caregivers' experiences with older adults' health care workers. This survey study constitutes a secondary analysis of a sample of 1916 family and unpaid caregivers to 1203 community-living older adults with activity limitations who participated in the 2017 National Health and Aging Trends Study. Data analysis was performed January to August 2019. Caregiver sociodemographic characteristics, caregiving intensity, and frequency speaking with or emailing older adults' health care workers. Caregiver-reported experiences when interacting with older adults' health care workers in the prior year, including being listened to, being asked about understanding of treatments, and being asked about help needed in managing older adults' care. Caregivers (mean [SE] age, 59.4 [0.5] years; 63.7% women) assisting community-living older adults with activity limitations reported that they never (56.3%), sometimes or rarely (33.0%), or often (10.7%) spoke with or emailed older adults' health care workers in the prior year. Most caregivers who interacted with older adults' health care workers reported being always (70.6%) or usually (18.2%) listened to and always (54.4%) or usually (17.7%) being asked about their understanding of older adults' treatments. Fewer caregivers reported being always (21.3%) or usually (6.9%) asked whether they needed help managing older adults' care, and nearly one-half (45.0%) were never asked. Caregivers who interacted with older adults' health care workers often (vs sometimes or rarely) were more likely to report being always or usually listened to (94.8% vs 86.9%; P = .004), being asked about understanding treatments (80.1% vs 69.5%; P = .02), and being asked about needing help (40.8% vs 24.1%; P < .001). No other exposures were consistently associated with caregiver experiences. Measures of caregiving intensity, including caring for an older adult with dementia, were not associated with being listened to or asked about understanding, but were associated with being asked about needed help. Although caregivers of persons with dementia were more likely than caregivers of persons without dementia to report always being asked about needed help (26.9% vs 19.0%), a high percentage in both groups were never asked (41.2% vs 46.5%) (P = .007). These findings reinforce the need for strategies to better support family and unpaid caregivers, who are the main source of assistance to older adults with physical and/or cognitive limitations.

Food Selection and Preferences of Omani Autistic Children.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core deficits in social interactions, verbal/nonverbal communication, and restricted, repetitive, and stereotyped behaviors. Children with ASD are known to have several feeding problems that are believed to affect their nutritional and health status. The present study was designed to assess the food preferences in Omani children diagnosed with ASD compared with controls. A case-control study was conducted in which 375 children (males and females) aged between 4 and 13 years were recruited. The sample consisted of 163 children with ASD and a control group of 212 typically developing (TD) children. For each participant, demographic, anthropometric, and medical information and information regarding dietary intakes were gathered using the food frequency questionnaire (FFQ) to assess their food preferences. The sociodemographic characteristics of caregivers were similar in the two groups, while their perceptions based on several nutritional parameters were different. Children's age and body mass index (BMI) were similar in both groups, while the number of male children was higher in ASD group (P<0.001). Problematic behaviors including food refusal and selectivity were significantly higher in ASD children than in TD children. Despite that, the children with ASD were found to consume mostly traditional Omani dishes. This is the first study that provides information on the eating habits and nutritional intake of Omani children diagnosed with ASD. The overall findings are promising and may contribute to further understanding of food preferences in children with ASD in Oman. Such information is highly valuable for the prevention and management of nutritional deficiencies among Omani children with autism by improving their diet quality.

Caregivers in home palliative care: gender, psychological aspects, and patient's functional status as main predictors for their quality of life.

This study aims to investigate the impact of possible predictors of quality of life (QoL) in a group of Italian caregivers assisting a cancer patient in home palliative care. Data from 570 adult informal caregivers and their cancer-affected relatives were collected. A multivariate regression analysis was conducted to assess the effect of three groups of variables on Caregivers Quality of Life Index-Cancer (CQOLC) scale: (a) socio-demographic characteristics of caregivers; (b) psychological characteristics of caregivers assessed by Profile Mood of States (POMS), Caregiver Burden Inventory (CBI), and Preparedness for Caregiving Scale (PCS); (c) Socio-demographic characteristics and functional status of the patients assessed by Karnofsky Performance Status (KPS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Regression analysis shows that some variables from each of these clusters are significantly associated with CQOLC, in particular: (a) the gender of the caregiver (st.β = .115, t = 2.765, p = .006) and the time spent for caregiving (st.β = - .165, t = - 3.960, p < .001); (b) the scores obtained by the caregivers in POMS,CBI (st.β = - .523, t = - 16.984, p < .001 and st.β = - .373, t = - 12.950, p < .001, respectively) and PCS (st.β = .092, t = 3.672, p < .001); (c) the gender (st.β = - .081, t = - 1.933, p = .045) and the IADL score (st.β = .195, t = 4.643, p < .001) of the patient. A multidimensional evaluation is a key strategy to identify the most vulnerable caregivers. Apart from the condition of the patient, the gender of the caregivers, the time spent for caregiving and, above all, their psychological condition are strong predictors of caregivers' QoL.

Differential determinants and reasons for the non- and partial vaccination of children among Nigerian caregivers

BackgroundVaccination has saved millions of lives. However, the vaccination rate in Nigeria remains low. We differentiate reasons for incomplete vaccination by status: not- and partially- vaccinated, and examine the association between sociodemographic characteristics of caregivers and reasons for incomplete vaccination. MethodsData from the Multiple Indicator Cluster Survey (MICS) conducted in Nigeria in 2016 and 2017 was analyzed. The logistic regression was used to evaluate associations between sociodemographic characteristics of caregivers and incomplete vaccination according to different reasons. ResultsThe most common reason for non-vaccination is that caregivers have no faith in immunization (27.0%), followed by lack of awareness of the need for immunization (26.0%) and the perception that the place where immunization is given is too far/inconvenient (24.3%). The most common reason for partial vaccination is that caregivers thought the children had already been fully immunized (44.8%), followed by the inconvenient location for immunization (15.3%) and supply-side issues such as shortage of vaccine stock and absence of vaccinators (14.4%). Among caregivers whose children are never vaccinated, a lower level of education is correlated with more likelihood of having no faith in immunization and poorer households are more likely to state a lack of awareness of the need for immunization need and an inconvenient place as the reasons for non-vaccination. Among caregivers whose children are only partially vaccinated, educated and wealthier caregivers are more likely to state that they thought their children were fully vaccinated, while poorer caregivers tend to give an inconvenient immunization place as the reason for incomplete vaccination. Supply-side barriers are not systematically correlated with educational attainment or wealth level of caregivers. ConclusionBarriers to vaccination are different according to vaccination status: not- and partially- vaccinated, as is the association between sociodemographic characteristics of caregivers and reasons for incomplete vaccination. The policy to increase vaccination take-up should take these differentials into consideration.

Psychosocial Burden Among Informal Caregivers of Adult Cancer Patients Attending a Tertiary Care Cancer Center in Coastal South India

Cancer is the most dreaded and chronic disease with its treatment lasting almost lifelong with an uncertainty of cure. This not only adversely affects the quality of life among patients but also poses a psychosocial burden among family members, especially caregivers of the patient. This study was conducted with the objectives to assess the psychosocial burden on caregivers of cancer patients and to find out the association of various sociodemographic characteristics with the level of burden among caregivers. Caregivers of 205 cancer patients were interviewed. Information on sociodemographic characteristics of caregivers, cancer details of patients, and psychosocial burden among caregivers was collected using Zarit Burden Interview (ZBI) scale. Descriptive statistics were used to analyze the baseline data. Chi-square test was done to find out the association of burden with various sociodemographic and disease variables. A p-value of &lt;0.05 was taken as statistically significant. The median (interquartile range) ZBI was 20 (10, 34). Fifty percent of the caregivers had no or minimal burden and only 2% had severe burden. Age of the caregiver was a significant determinant of their psychosocial burden.

Levels of Satisfaction, Workload Stress and Support Amongst Informal Caregivers of Patients Receiving or Not Receiving Long-Term Home Nursing Care in Poland: A Cross-Sectional Study.

The role of informal caregivers was included in the Assumptions of the Long-Term Senior Policy in Poland for 2014–2020. The document acknowledged the necessity of diagnosing the needs of informal caregivers of elderly people and to implement systemic solutions that would enable the provision of assistance for them. In response, this study aimed to describe the situation of caregivers of patients receiving versus patients not receiving Long-Term Home Nursing Care (LTHNC; i.e., a formal program including regular visits by a nurse specializing in home care) in terms of caregiver socio-demographic characteristics, health self-assessment, work overload, satisfaction derived from being a caregiver, and the quality of perceived support. A cross-sectional study was conducted using the Carers of Older People in Europe (COPE) Index in 2015 in the north-eastern part of Poland involving 170 caregivers of patients supported with LTHNC and 86 caregivers of patients staying at home and not receiving LTHNC. We found that caregivers for patients receiving LTHNC were significantly less overloaded with care work than caregivers for patients without LTHNC support (p < 0.001). LTHNC support was also related to the level of satisfaction with providing care: Caregivers for patients receiving LTHNC were significantly more satisfied with performing their role and felt greater support than caregivers for patients without LTHNC (p < 0.001). Our study provides evidence for a positive relationship between LTHNC and the situation of informal caregivers of dependent elderly people at home. A formal program of visits by a nurse specializing in long-term home care may facilitate the provision by caregivers of better informal care to patients staying at home.