Caregiver Stress Management Research Articles

Perceived Readiness for Gerontological Social Work: Insights from Recent Graduates During COVID-19

ABSTRACT An online qualitative survey explored perceived training, readiness, and needs of recent SW graduates serving older adults. Over half (N = 14) held a master’s in social work, with 70% having taken an introductory aging course. Nearly halfcompleted other aging-specific coursework, and 80% did fieldwork with older adults. Participants indicated moderate proficiency in assessing issues like lossestransitions (46.7%), and physical health (53.3%), and advanced expertise in cognitive assessments (60.0%) and caregiver stress management (53.3%). Training deficiencies were noted in disaster readiness, telehealth, and resource coordination. Findings underscore the need for educationfor early-career social workers, ensuring their effective support to older adults.

Advancing Preservice Consultation Training Through University-Community Partnership

ABSTRACT This paper describes consultation training experiences offered through a decades-long partnership between a university school psychology graduate program and a local Head Start center. The collaboration provides a field placement setting where beginning students engage in activities tied to first-year coursework, and an advanced practicum site for doctoral students who oversee first-year students’ classroom-based activities and in turn are jointly supervised by program faculty and the center’s Special Services Manager. Through these experiences, graduate students develop competencies in client-centered, consultee-centered, and systems-level consultation, with opportunities to engage in an array of activities aligned with key updates to the 2020 NASP Professional Standards particularly in Domains Six (Services to Support Safe and Supportive Schools), Seven (Family, School, and Community Collaboration), and Eight (Equitable Practices for Diverse Student Populations). By focusing on the school environment, community collaboration, social justice, and equitable practices, these updated domains highlight the role of ecological and systemic factors in school psychology practice and training. Trainees support the center’s efforts to function as a trauma-informed organization whose members recognize and respond to trauma in a manner that promotes safety, collaboration, empowerment, and other trauma-informed practice principles. They do this by consulting with parents and teachers, contributing to staff professional development on such topics as adverse childhood experiences and caregiver stress management, and facilitating meetings with parents and teachers around issues such as trauma-informed discipline. We discuss how these activities align with the 2020 NASP domains, with particular attention to ecological and systemic perspectives.

Patterns in older adults' perceived chronic stressor types and cognitive functioning trajectories: Are perceived chronic stressors always bad?

PurposePrevious studies have linked levels of perceived chronic stress to older adults' cognitive functioning, but few have focused on the impact of chronic stressor types. Thus, this study aimed to (1) identify patterns of chronic stressor types and (2) examine the effects of these patterns on cognitive functioning trajectories among older adults. MethodsTwo longitudinal studies were conducted separately to test the study aims and ensure replicability across samples and time points. Both used three timepoints (Study 1: 2006, 2008, and 2010, n = 6974; Study 2: 2012, 2014, and 2016, n = 6604) collected from older Americans in the Health and Retirement Study. Participants did not overlap between the two studies. Latent class analyses were conducted to identify chronic stressor-type patterns. Latent growth curve models were used to test the effects of chronic stressor-type patterns on cognitive functioning trajectories. ResultsThree latent classes of stressor types were identified in both studies: egocentric (4.56%; 5.85%), nonegocentric (8.58%; 10.03%), and low stressor (86.86%; 84.12%). In both studies, compared to the low stressor class, the egocentric stressor class had significantly lower initial cognitive scores (B = −0.72, ρ < 0.001; B = −0.46, ρ < 0.05), while the nonegocentric stressor class did not have significantly different initial scores, with covariates controlled. Additionally, in Study 1, the nonegocentric stressor class had significantly slower cognitive decline rates than the low stressor class (B = 0.11, ρ < 0.05). ConclusionsFindings suggested that nonegocentric stressors are an important stressor source in late adulthood but are less detrimental to cognitive functioning than egocentric stressors. Health management interventions may reduce older adults' cognitive health disparities caused by self-health and financial stressors. More support, including financial subsidies, caregiver stress management training, or support groups, should be provided to older caregivers, especially those with few resources.

PENGARUH STRATEGI COPING TERHADAP TINGKAT STRES PADA CAREGIVER INFORMAL YANG MERAWAT PENDERITA SKIZOFRENIA DI POLI RAWAT JALAN RUMAH SAKIT JIWA DR. SOEHARTO HEERDJAN JAKARTA BARAT

Limited psychiatric healthcare and being chronic, schizophrenia makes schizophrenia patient’s family hold important role as informal caregivers. Objective of this research was to know demography characteristic distribution and impact of coping strategy against schizophrenia informal caregiver’s stress level at Dr. Soeharto Heerdjan psychiatric hospital, out-patient unit. Coping stress vary depends on individual characteristics. This research was set to observational analytic with cross sectional design. Subjects of research were 32 caregivers, adapting research instrument CSI-SF 32 items and PSS-14 items. The result of research, majority of the caregivers is a woman and middle adulthood age. Most of caregivers goes to work and tend more than 4 years with nursing time more than 6 hours /day. There was impact of coping strategy against stress level of schizophrenia informal caregivers (p = 0,006). Most used coping strategy was adaptive coping with medium stress level. Long term could increase caregivers burden, so that it can trigger stress and could lower caregivers mental health status and could affect the treatment quality for schizophrenia patient. Writer recommended psychiatric healthcare to put psychological awareness and psycho-education intervention of stress management for caregivers.

A randomized control trial of stress management for caregivers of stem cell transplant patients: Effect on patient quality of life and caregiver distress

Psychological interventions reduce caregiver distress (CG-distress). Less distress in caregivers may contribute to improved patient quality of life (QoL), but empirical evidence is lacking. Will a caregiver stress management intervention improve patient QoL? In this replication study, we randomized 155 allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients and caregivers to PsychoEducation, Paced Respiration, and Relaxation (PEPRR) or enhanced treatment as usual (eTAU). We provided PEPRR over 3 months following transplant. Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) evaluated patient QoL, and CG-distress was based on depressive, anxious, and stress symptoms. Hierarchical linear models tested intervention, time, and interactions as fixed effects with participant as random effects. Patients whose caregivers received PEPRR did not differ on FACT-BMT between baseline and 6 months (mean = +3.74; 95% CI, -3.54 to 11.02) compared with patients of caregivers in eTAU (mean = +3.16; 95% CI, -2.88 to 9.20) even though CG-distress was decreased by PEPRR (mean = -0.23; 95% CI, -0.448 to -0.010) compared with those receiving eTAU (mean = +0.27; 95% CI, 0.033-0.504) at 6 months. PEPRR reduced CG-distress without affecting their patient's FACT-BMT score. The FACT-BMT may not have distinguished unique psychological changes associated with their caregiver receiving PEPRR.

Correction of: Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups.

[This corrects the article DOI: 10.2196/resprot.7075.].

Development of a Web-Based Intervention for Addressing Distress in Caregivers of Patients Receiving Stem Cell Transplants: Formative Evaluation With Qualitative Interviews and Focus Groups

BackgroundCaregivers of cancer patients experience significant burden and distress including depression and anxiety. We previously demonstrated the efficacy of an eight session, in-person, one-on-one stress management intervention to reduce distress in caregivers of patients receiving allogeneic hematopoietic stem cell transplants (allo-HSCT).ObjectiveThe objective of this study was to adapt and enhance the in-person caregiver stress management intervention to a mobilized website (eg, tablet, smartphone, or computer-based) for self-delivery in order to enhance dissemination to caregiver populations most in need.MethodsWe used an established approach for development of a mhealth intervention, completing the first two research and evaluation steps: Step One: Formative Research (eg, expert and stakeholder review from patients, caregivers, and palliative care experts) and Step Two: Pretesting (eg, Focus Groups and Individual Interviews with caregivers of patients with autologous HSCT (auto-HSCT). Step one included feedback elicited for a mock-up version of Pep-Pal session one from caregiver, patients and clinician stakeholders from a multidisciplinary palliative care team (N=9 caregivers and patient stakeholders and N=20 palliative care experts). Step two included two focus groups (N=6 caregivers) and individual interviews (N=9 caregivers) regarding Pep-Pal’s look and feel, content, acceptability, and potential usability/feasibility. Focus groups and individual interviews were audio-recorded. In addition, individual interviews were transcribed, and applied thematic analysis was conducted in order to gain an in-depth understanding to inform the development and refinement of the mobilized caregiver stress management intervention, Pep-Pal (PsychoEducation and skills for Patient caregivers).ResultsOverall, results were favorable. Pep-Pal was deemed acceptable for caregivers of patients receiving an auto-HSCT. The refined Pep-Pal program consisted of 9 sessions (Introduction to Stress, Stress and the Mind Body Connection, How Thoughts Can Lead to Stress, Coping with Stress, Strategies for Maintaining Energy and Stamina, Coping with Uncertainty, Managing Changing Relationships and Communicating Needs, Getting the Support You Need, and Improving Intimacy) delivered via video instruction through a mobilized website.ConclusionsFeedback from stakeholder groups, focus groups, and individual interviews provided valuable feedback in key areas that was integrated into the development of Pep-Pal with the goal of enhancing dissemination, engagement, acceptability, and usability.

A randomized controlled pilot study of inflammatory gene expression in response to a stress management intervention for stem cell transplant caregivers.

Few studies have addressed whether stress-associated physiological changes in caregivers are reversible by psychological interventions mitigating distress. We report on pro-inflammatory, sympathetic, and oxidative stress gene expression in response to stress management for caregivers of allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients. Following randomization by permuted block to either treatment as usual (TAU, n = 11) or a stress management intervention (PsychoEducation, Paced Respiration, and Relaxation, PEPRR, n = 13), twenty-four caregivers were selected at the conclusion of a larger trial of 149 caregivers. PEPRR was provided one-on-one beginning around transplant. Genome-wide transcriptional profiling was conducted on peripheral blood mononuclear cells collected prior to randomization and on completion of PEPRR 3 months post-transplant. Bioinformatics analysis of differentially expressed genes indicated reduced activity of transcription control pathways associated with inflammation (NF-κB), sympathetic nervous system (CREB), and oxidative stress (NRF2) in caregivers receiving PEPRR compared to TAU aligning with reductions in stress, depression, and anxiety. This suggests that PEPRR may alter transcriptomic effects reported for distressed individuals.

Perceptions of caregiver distress, health behaviors, and provider health-promoting communication and their relationship to stress management in MS caregivers

This study applied the Stress/Health Model to examine a novel approach for promoting stress management among 67 caregivers of persons with multiple sclerosis, who often face unique caregiving challenges. Hierarchical regressions indicated that caregiver distress (i.e., emotional burden) and engagement in other health-promoting activities (i.e., controlling alcohol use) were the best predictors of caregiver stress management. Communication with the MS care recipient’s health provider about caregiver engagement in health-promoting activities was associated with caregiver stress management, but not significantly more so than explained by the other factors (i.e., caregiver distress and engagement in health-promoting behaviors). A more controlled study would be indicated to further explain how to encourage, within the medical setting, caregiver engagement in self-care activities.

Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents.

To examine changes in parent depression, psychological distress, parenting stress, and self-efficacy among participants in a randomized trial of a Web-based parent training program for pediatric traumatic brain injury (TBI). Primary caregivers of 37 children aged 3 to 9 years who sustained a moderate/complicated mild to severe TBI were randomly assigned to the intervention or control group, and both groups were equipped with home Internet access. The online parent training program was designed to increase positive parenting skills and improve caregiver stress management. It consisted of 10 core sessions and up to 4 supplemental sessions. Each session included self-guided Web content, followed by a videoconference call with a therapist to discuss content and practice parenting skills with live feedback. Families in the control group received links to TBI Web resources. Parent income moderated treatment effects on parent functioning. Specifically, lower-income parents in the parenting skills group reported significant reductions in psychological distress compared with lower-income parents in the control group. No differences were found among higher-income parents for depression, parenting stress, or caregiver efficacy. Parent training interventions post-TBI may be particularly valuable for lower-income parents who are vulnerable to both environmental and injury-related stresses.

Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being

We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients. We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group. We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden. An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.

Feasibility and Preliminary Efficacy of a Web-Based Parenting Skills Program for Young Children With Traumatic Brain Injury

To report the feasibility and preliminary efficacy of a Web-based parenting skills program to reduce behavior problems following traumatic brain injury (TBI) in young children. Families of 9 children between the ages of 3 and 8 years with TBI, injured less than 24 months earlier, participated in a pilot study of a Web-based parenting skills program designed to increase positive parenting skills and to improve caregiver stress management and coping. The program consisted of 10 core sessions and up to 4 supplemental sessions. Each session consisted of self-guided didactic information, video modeling skills, and exercises. Online sessions were followed by synchronous sessions providing in vivo coaching of target skills. Caregivers completed an average of 12 sessions (range 5-24). Ratings of ease of use and satisfaction were high. Paired t tests revealed significant improvements in target parenting behaviors between baseline and session 2 and between sessions 2 and 4. These improvements were maintained at follow-up. Among the 5 families who completed the follow-up assessment, there were trends for reductions in the overall number of behavior problems. This study provides preliminary evidence of the potential feasibility and efficacy of an online parenting skills intervention for improving positive parenting skills and for reducing child behavior problems following early TBI.

Palliative Care Providers’ Perspectives on Service and Education Needs

To obtain the information necessary for coordinated regional program development, we examined (a) the multidisciplinary viewpoint of palliative care service provision and (b) the continuing education needs reported by non-physician service providers. Of 146 surveys distributed to care providers from multiple settings, 135 were returned. Respondents cited these problems: fragmented services, poor pain and symptom control, lack of education for providers, lack of public awareness, problems with the continuity and coordination of care, lack of respite, and lack of hospice beds. Stress management for caregivers, pain management, communication skills, and symptom assessment were rated as priorities in continuing education. Lectures, small group discussions, practicum, and regular medical centre rounds were the preferred learning formats, while costs and staff shortages were cited as educational barriers.

Identifying the Responsibilities &amp; Needs of WORKING ADULTS WHO ARE PRIMARYCAREGIVERS

1. Caregivers of the elderly are mostly married women caring for mothers by completing household chores and personal care, managing finances and providing financial support, transportation, and companionship. 2. Caregivers attribute a variety of health care problems related to the burden of caregiving and miss an average of 8 days of work a year related to caregiving responsibilities. 3. The majority of caregivers express ten educational needs that would be helpful in their caregiving activities.

Coping with Caregiving: Stress Management for Caregivers of the Elderly

Coping with Caregiving: Stress Management for Caregivers of the Elderly