Caregiver Anxiety Research Articles

Developmental differences in infants due to parental caregiving anxiety and parents’ parenting knowledge during the COVID-19 pandemic in South Korea

ABSTRACT The main purpose of this study was to investigate developmental differences in Korean infants based on parenting knowledge and parental caregiving anxiety experienced during the COVID-19 pandemic. The study targeted infants aged 0 to 42 months residing in S City, Gyeonggi Province, South Korea.Frequency analysis was conducted to examine the general characteristics of the study participants, and Cronbach’s α was calculated to assess the reliability of the measurement tools. Cross-tabulation analyses were performed to address research questions, and when cells had expected frequencies of less than 5 and accounted for more than 25% of the total, Fisher-Freeman-Halton exact tests were applied. Subsequently, Bonferroni tests were conducted as nonparametric post-hoc tests when significant differences were identified.The summarized results of the analysis based on the research questions are as follows:Firstly, regarding the differences in developmental levels of infants according to parenting knowledge, a significant difference was found in the social-emotional development domain of children. Secondly, concerning the differences in developmental levels of infants based on parental caregiving anxiety, significant differences were observed in the language and social-emotional domains.These results are expected to help raise awareness of the importance of parental psychological factors children’s language development, beyond just parental caregiving anxiety. It is anticipated that this will serve as a meaningful foundational study for understanding the influence of various psychological factors of parents on their children’s language development.

The impact of perceived caregiver anxiety and stress during childhood on late-life depression: evidence from the China Health and Retirement Longitudinal Study

The impact of perceived caregiver anxiety and stress during childhood on late-life depression: evidence from the China Health and Retirement Longitudinal Study

Comprehensive assessment of caregiver burden and strain in early-stage Parkinson's disease: An exploratory study.

Parkinson's Disease (PD) is a progressive neurodegenerative disorder affecting motor and cognitive functions, reducing the quality of life (QoL) for both patients and caregivers. This study explored correlations between clinical and psychological factors in early-stage PD patients and their caregivers, focusing on disease burden and caregiver stress. Nineteen PD patients and their caregivers were assessed. For patients, we evaluated disease severity (Hoehn and Yahr), cognitive functions (Montreal Cognitive Assessment, MoCA), anxiety levels (Hamilton Rating Scale for Anxiety, HRS-A), and quality of life (Parkinson's Disease Questionnaire, PDQ-39). For caregiver, we assessed caregiver burden (Caregiver Burden Inventory, CBI), functional social support (Family Strain Questionnaire, FSQ), and anxiety level (HRS-A). Spearman's correlation analyzed relationships between patient factors and caregiver burden. Cognitive impairment (MoCA) negatively correlated with patient QoL (PDQ-Cogn; r = -0.48, p = 0.04). Caregiver anxiety (HRS-A) was positively correlated with physical (r = 0.65, p = 0.003) and emotional stress (r = 0.57, p = 0.01), and higher family stress (FSQ). Our study highlights the complex relationships between clinical and psychological factors in PD patients and their caregivers. This supports the need for integrated approaches that address the clinical management of PD and the caregivers' psychological well-being.

Effectiveness of the Mindfulness-Based Interventions for Caregivers of Patients with Amyotrophic Lateral Sclerosis: A Scoping Review

Informal caregivers of patients with amyotrophic lateral sclerosis (ALS) experience an increased caregiver burden as the disease progresses. Supportive interventions for caregivers are available and continue to be developed. One of the supportive intervention methods is mindfulness-based interventions, and despite the growing evidence on this topic, there is a lack of studies compiling information about interventions for caregivers of patients with ALS. This study aimed to evaluate and summarize the current scientific literature on the effectiveness of mindfulness-based interventions for informal caregivers of the patients with ALS. A scoping review was conducted using electronic databases such as Ebsco, Scopus, Pubmed and Web of Science. A total of 315 studies were identified by searching through databases and other sources. After screening the titles and abstracts, 19 studies remained for fulltext review. Finally, 5 studies were included in this scoping review. In particular, answers were sought to the questions "What is effect of mindfulness-based interventions for caregivers of patients with ALS on caregiver burden?", “What evidence is there for the acceptability and effectiveness of mindfulness-based interventions for caregivers of the patients with ALS?” It was demonstrated that mindfulness-based interventions could be an effective supporting approach for caregivers of patients with ALS. The findings of this scoping review reveal that mindfulness-based interventions can have a positive impact on caregiver burden, quality of life, and psychological well-being such as anxiety and depression in caregivers of patients with ALS, despite limited studies.

Longitudinal study of care needs and behavioural changes in people living with dementia using in-home assessment data

BackgroundPeople living with dementia often experience changes in independence and daily living, affecting their well-being and quality of life. Behavioural changes correlate with cognitive decline, functional impairment, caregiver distress, and care availability.MethodsWe use data from a 3-year prospective observational study of 141 people with dementia at home, using the Bristol Activities of Daily Living Scale, Neuropsychiatric Inventory and cognitive assessments, alongside self-reported and healthcare-related data.ResultsHere we show, psychiatric behavioural symptoms and difficulties in activities of daily living, fluctuate alongside cognitive decline. 677 activities of daily living and 632 psychiatric behaviour questionnaires are available at intervals of 3 months. Clustering shows three severity-based groups. Mild cognitive decline associates with higher caregiver anxiety, while the most severe group interacts more with community services, but less with hospitals.ConclusionsWe characterise behavioural symptoms and difficulties in activities of daily living in dementia, offering clinically relevant insights not commonly considered in current practice. We provide a holistic overview of participants’ health during their progression of dementia.

Desfechos relacionados à saúde mental em cuidadores de pessoas com demência: uma revisão sistemática de intervenções baseadas em yoga

ABSTRACT Mind-body interventions have been explored to enhance the psychological well-being of dementia caregivers; however, the specific effects of yoga practice remain underexamined. Objective: The aim of this study was to investigate the benefits of yoga on quality of life (QoL), life satisfaction, psychological well-being, attention, self-compassion, perceived stress, anxiety, depression, and caregiver burden for dementia caregivers. Methods: A comprehensive search was conducted on September 11, 2024, in databases including SciELO, PubMed, BVSalud, Web of Science, Embase, and PsycINFO, focusing on the effects of yoga for informal dementia caregivers compared to passive or active control groups through randomized and non-randomized trials. An initial review reduced 284 to 180 unique records; 172 studies were excluded, leaving 8 that met the inclusion criteria. Two authors independently selected and extracted data using a data extraction sheet based on the Cochrane Consumers and Communication Review Group. The Cochrane Risk of Bias tools (ROB2 and ROBINS-I) were employed to evaluate bias risk. Results: The review included three randomized and five non-randomized studies with a total of 161 participants, predominantly female (wives and daughters), with ages ranging from 39 to 76 years. Four studies utilized hatha yoga, while four employed non-traditional yoga. Significant improvements were observed in QoL, depression, stress, anxiety, and self-compassion, but not in caregiver burden. Furthermore, positive effects were more pronounced in face-to-face or online interventions than in recorded videos. On average, studies exhibited a moderate risk of bias. Conclusion: Yoga practice can serve as an effective intervention for enhancing the psychological aspects of dementia caregivers.

Emotional ecosystems: Understanding the relationship between family interactions and anxiety among cancer caregivers.

Recent studies have challenged the assumption that families are invariable sources of support for cancer caregivers, noting that relationships with family members can have both positive and negative effects on caregiver well-being. This study expands upon prior literature to examine the relationship between cancer caregivers' perceptions of the quality of their family interactions and their symptoms of anxiety. We employed secondary analysis of baseline data from a multisite randomized clinical trial of an intervention for cancer caregivers conducted at 3 large academic palliative care clinics. We performed linear regression analyses to analyze the relationship between caregivers' perceptions of the quality of their family interactions and their symptoms of anxiety; additional models were estimated to further characterize this relationship with the addition of relevant covariates: race, ethnicity, sex, marital/relationship status, relationship to patient, employment status, household income, and perceived social support received from friends and significant others. We also conducted a sub-analysis of data provided by caregivers who were married or partnered to examine the relationship between their perceptions of the quality of their family interactions and their symptoms of anxiety with relationship satisfaction as a covariate. Among our analytic sample (n = 244), we identified a significant negative relationship between cancer caregivers' perceptions of the quality of their family interactions and their symptoms of anxiety; this relationship remained statistically significant with the addition of covariates. Relationship satisfaction was not found to be a statistically significant covariate in our sub-analysis of married or partnered caregivers. Study results provide strong support for the development, testing, and implementation of interventions to improve family interactions as a strategy to reduce caregiver anxiety.

Improving Dementia Home Caregiving and Restructuring the Dementia Narrative Through Creating a Graphic Memoir and Engaging in a Psychoanalytic Narrative Research Method

Informal dementia home caregiving is viewed negatively by society and can result in caregiver depression and anxiety from burnout, potentially compromising caregiving. Caregiver creation of a graphic memoir may help to mitigate the negative dementia narrative while engaging in it, and a psychoanalytic narratology method may reduce experienced depression and anxiety associated with burnout. This investigation examines writing, illustrating, and publishing a graphic memoir by one informal dementia home caregiver. As the mother of the illustrator and the editor and publisher of this graphic memoir, I provide the perspective of this investigation based on communications with the author and illustrator. My historical analysis, in which the author participated, represents psychoanalytic narrative research, serving as the historical method. The effects of writing, illustrating, and publishing the graphic memoir were able to reduce the informal dementia home caregivers’ symptoms during the entire process and extend the effect of this endeavor until the death of the mother. Engaging in the psychoanalytic narrative research process was additionally effective in this regard. The outcomes demonstrate the viability of writing and illustrating a publishable graphic memoir for other informal dementia home caregivers and the possibility of it and the narrative research method to help decrease their depression and anxiety regarding burnout.

Relationship between anxiety and poor sleep quality in family caregivers of psychiatric patients based on history of sharp object injuries: a case-control study in Bitlis, Turkey

ObjectivesThis study aims to investigate the relationship between anxiety levels and poor sleep quality among family caregivers of psychiatric patients, based on the history of sharp object injuries (SOI) inflicted...

Assistive Communication Device Used During Pediatric Noninvasive Ventilation.

Noninvasive ventilation therapy is a common approach in acute respiratory failure as an alternative to invasive mechanical ventilation. Assistive communication strategies are necessary to overcome communication impairments and anxiety caused by oronasal obstruction in pediatric intensive care unit patients undergoing noninvasive ventilation. A 7-year-old girl was admitted with a history of pulmonary arterial hypertension and recurrent respiratory failure requiring bilevel positive airway pressure intervention. The patient experienced initial lack of bilevel positive airway pressure mask compliance due to oronasal mask discomfort. The trial of a novel communication device (SPEAX, Ataia Medical) involving a microphone that attaches to the patient's bilevel positive airway pressure mask for enhanced communication. Use of the assistive communication device was associated with increased intelligibility to familiar listeners, mask compliance, enhanced mobility, and reduced patient anxiety levels throughout hospitalization and in later episodes of readmission. The implementation of assistive communication devices can alleviate communication barriers in pediatric bilevel positive airway pressure users, contributing to increased compliance and diminished anxiety for patients and caregivers. Providing a pathway for effective communication may reduce sedation use, minimizing risks of sedation-related delirium and improving overall quality of life in these patients.

A systematic review of depressive and anxiety symptoms in caregivers of dementia patients.

The current number of dementia cases in Europe stands at 7.7 million, a figure projected to double by 2050. Caregivers of individuals with dementia experience a heightened burden compared to those caring for other chronically ill individuals, increasing the risk of depression and stress disorders. This systematic literature review, following PRISMA guidelines, explores the prevalence of anxiety and depressive symptoms in dementia caregivers. Searches in academic databases, restricted to studies from the last 15 years, identified 85 articles with 16 meeting the inclusion criteria. Results indicate significant caregiver burden, diminished self-reported quality of life, and a propensity for clinical depression. Depression and anxiety symptoms were more pronounced among female caregivers. Caregiver depression correlated with increased emergency department utilization by dementia patients, with a surge in depressive symptoms reported during the COVID-19 pandemic. Caregiving for dementia patients was associated with burnout, adversely impacting caregiver quality of life. Depression and anxiety symptoms in caregivers correlated with substance use. Sociodemographic variables, including low socioeconomic status, high urbanization levels, and older age, were associated with caregiver depression. Caregivers of individuals with Alzheimer's disease reported higher anxiety, burden, and depression scores compared to those assisting individuals with other dementias, particularly when neuropsychiatric symptoms were evident. The identification of the factors that are linked to the mental burden of caregivers allows mental health professionals to enhance symptom detection and provide tailored support, ultimately alleviating caregiver burden and improving dementia care quality. Systematic professional assistance and training opportunities through health policies can effectively alleviate caregiver burden.

Development and Validation of the Dementia‐Perceived Abuse and Neglect Questionnaire (D‐PANQ) among Family Caregivers of People Living with Dementia

AbstractBackgroundAbuse of older adults is a sociopolitical issue that is often hidden. People living with dementia are more vulnerable to abuse due to their cognitive and physical impairments. Caring for a person with dementia is quite challenging. The caregivers abuse the older adults they take care of due to the increasing caregiving demands, caregiver burden, stress, depression, or anxiety. The caregivers often know what the potentially abusive behaviors are and what not to do, but at times they tend to behave in an abusive way. Some of the situations that happen in a day that are abusive are not perceived as such by them due to the normalization of what they have been doing for years. A vignette‐based tool helps to collect data regarding sensitive issues like abuse. The objective of this study was (1) to analyze the psychometric properties of the Dementia‐Perceived Abuse and Neglect Questionnaire (D‐PANQ) among family caregivers of people living with dementia regarding abuse using a newly developed vignette‐based tool. (2) to assess the perception of family caregivers of people living with dementia regarding abuse.MethodThis cross sectional study will be completed among 300 caregivers of people living with dementia. The study is ongoing, with data collected from 190 caregivers. The tool is a 22‐item, 4‐point scale with a maximum score of 66. The higher scores show a high perception of abuse, and the low scores show a low perception of abuse.ResultThe interim analysis among 190 caregivers shows that the perception of abuse is high. The mean DPANQ score was 42.86, with a standard deviation of 16.01. The reliability of the tool was established by Cronbach’s alpha. It was found to be 0.82. Further analysis of the questionnaire’s feasibility, reliability, internal consistency, content validity, and construct validity (factor analysis and convergent validity) will be done once the study is completed.ConclusionThe initial analysis shows that the tool is valid, reliable, and feasible to assess the perception of family caregivers of people living with dementia regarding abuse, and this would be the first tool to assess the perception of dementia carers towards abuse and neglect.

Caregiver burden among informal caregivers of stroke survivors in Harare, Zimbabwe.

Stroke presents significant challenges for both survivors and caregivers, particularly in resource-limited settings like Zimbabwe. Identifying factors contributing to caregiver burden strain (CBS) is crucial to enhance support strategies. This longitudinal study identified caregiver and stroke survivor characteristics associated with CBS among caregivers in Harare, Zimbabwe. Altogether 188 stroke survivors and their caregivers participated with CBS assessed at 3 months and 12 months using the Caregivers Strain Index. Multiple linear regression was used to evaluate the association of explanatory variables with CBS. Model fit was evaluated using the Akaike's Information Criterion and R 2. Caregivers experiencing anxiety or depression showed increased CBS at 3 months (β = 2.46, p < 0.001) and 12 months (β = 2.73, p = 0.016). Work adjustments were associated with higher CBS at 3 months (β = 3.84, p < 0.001). Caregivers feeling overwhelmed had significantly higher CBS at 3 months (β = 3.36, p < 0.001). Stroke survivors' poor physical outcomes and reliance on health insurance were associated with CBS at 12 months (β = 4.34, p = 0.006). Caring for married stroke survivors was associated with reduced CBS (β = -2.83, p < 0.001). Caregiver anxiety, depression, work adjustments and poor physical and social outcomes in stroke survivors contributed to increased CBS. Targeted interventions addressing mental health and social support are essential to reduce CBS. Multifaceted interventions that address caregiver mental health and social support are vital to reduce CBS and improve outcomes in resource-constrained settings like Zimbabwe.

Caregiving burden, depression, and anxiety in informal caregivers of people with mental illness in China: a cross-sectional survey

BackgroundCaregiving for people with mental illness (PwMI) could be burdensome, especially for informal caregivers. However, there is a scarcity of research investigating caregiving burden among informal caregivers of PwMI in China at the national level. To fill this gap, this study examined the prevalence of caregiving burden, depression, and anxiety, as well as their associated factors, among a cross-sectional sample of informal caregivers of PwMI in China.MethodsData were collected via an online survey between June and November 2023. Caregiving burden, depression, and anxiety were measured by the Zarit Burden Interview, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Information on caregivers’ sociodemographic, care recipients’ sociodemographic and disease-related, and caregiving-related characteristics was also collected. Hierarchical regression analyses were performed to identify associated factors of caregiving burden, depression, and anxiety.ResultsA total of 1,224 informal caregivers of PwMI in China were included in the final analysis. 72.1% of the participants had high caregiving burden, 53.5% had moderate to severe depression, and 43.1% had moderate to severe anxiety. Caregiving burden, depression, and anxiety were inter-correlated with each other but exhibited different profiles of associated factors. The most important factors associated with all the three outcomes were disease-related characteristics, particularly care recipients’ symptom stability, medication compliance, and insight. Informal caregivers of males with mental illness had higher levels of caregiving burden, depression, and anxiety than those of females. There was a lack of differentiation in caregiving burden, depression, and anxiety based on care recipients’ diagnosis. Formal or common-law marriage was a protective factor for caregiver depression and anxiety but not for caregiving burden.ConclusionInformal caregivers of PwMI in China experienced a high level of caregiving burden, depression, and anxiety. Urgent actions are needed to relieve caregiving burden, depression, and anxiety among informal caregivers of PwMI in China.

QOL-10. AN ASSESSMENT TOOL FOR MEASURING CAREGIVERS’ DEATH ANXIETY IN PRIMARY BRAIN TUMOR: A CONFIRMATORY FACTOR ANALYSIS

Abstract BACKGROUND Caregivers of patients with primary brain tumor describe significant emotional distress regarding their loved one’s impending trajectory and eventual mortality—a construct known as death anxiety. Our team adapted a pre-existing, validated scale for patients with advanced cancer (the Death and Dying Distress Scale; DADDS) to measure this latent variable in caregivers of patients with primary brain tumors. Our adapted scale (DADDS-CG) demonstrated preliminarily strong internal consistency and construct validity. We now seek to confirm the factor structure, internal consistency, and convergent validity of the DADDS-CG in a second sample of neuro-oncology caregivers in accordance with best practices of measure development. METHODS Caregivers of those with primary brain tumors (N=221) completed an online battery of self-report questionnaires, including the 15-item Death and Dying Distress Scale-Caregiving (DADDS-CG), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9). To verify the two-factor structure of the DADDS-CG, we used confirmatory factor analysis. Cronbach’s alpha measured internal consistency, Pearson correlations assessed convergent validity, and descriptive statistics determined the prevalence of death anxiety. RESULTS Caregivers (Mage=46.2) were primarily White (85.5%) female (72.4%) spouses (75.6%). The two-factor model demonstrated adequate fit (X2/df=4.24; CFI-.89; NFI=.87; RMSEA=.06), suggesting two correlated subscales of death anxiety: Finitude and Dying (r=.80). The DADDS-CG demonstrated strong internal consistency (a=.95) and was moderately correlated with the GAD-7 (r=.73) and PHQ-9 (r=.68), suggesting adequate convergent validity. Mean scores fell within the moderate range (M=40.5, SD=18.7), with 20.8%, 36.2%, and 43.0% of caregivers reporting low, moderate, and severe death anxiety, respectively. CONCLUSION The DADDS-CG is a valid and reliable assessment tool for measuring death anxiety in caregivers of those with primary brain tumors. Given the high prevalence of death anxiety, future investigations are needed to understand caregiver’s death anxiety throughout the disease trajectory and to inform intervention development for neuro-oncology caregivers.

Subjective and objective effects of anxiety and fatigue on social function in patients with enterostomy and their family caregivers.

Many patients with enterostomy and their family caregivers experience severe anxiety and fatigue, which affects their participation in normal social activities and family life, resulting in impaired social function. The purpose of this study was to understand the status of social function of patients with enterostomy and their family caregivers;at the same time to analyze the subjective and objective effects of anxiety and fatigue on their social functions. The self-made general information questionnaire, WHO Social Disability rating Scale, Miao Yu's Multidimensional Fatigue Scale-20 and Zung et al. 's Self-rating Anxiety Scale were used to investigate the general situation, social function, fatigue and anxiety of enterostomy patients and their family caregivers who came to the hospital for treatment from March 28, 2023 to November 30, 2023. SPSS27.0 was used to complete the statistical analysis of the data, and AMOS26.0 was used to establish the structural equation model to complete the subject and object effect analysis. A total of 260 pairs of enterostomy patients and their family caregivers were included in this study. The social function scores of enterostomy patients and their family caregivers were (8.80±3.44) and (6.44±3.60). The anxiety scores were (37.81±7.60) and (34.73±7.50). The fatigue scores were (63.35±12.80) and (51.21±12.38).The results of the subject-object effect analysis reported the subject effect: the anxiety of patients with enterostomy had a significant positive impact on the degree of social dysfunction (β = 0.154, P = 0.015); The fatigue of patients with enterostomy had a significant positive effect on the degree of social dysfunction (β = 0.132, P = 0.034). The anxiety of family caregivers had a significant positive effect on the degree of social dysfunction (β = 0.161, P = 0.023). The fatigue of family caregivers had a significant positive effect on the degree of social dysfunction (β = 0.201, P = 0.005). In terms of object effects: only the fatigue of family caregivers had a significant positive impact on the degree of social dysfunction of enterostomy patients (β = 0.224, P < 0.001), and other ways had no object effects. Patients with enterostomy and their family caregivers have serious social function defects. Clinical medical staff should take care of them as a whole in order to better return to family and society after surgery.

Quality of life and mental health status in caregivers of pediatric patients with nephropathic cystinosis.

There are few studies assessing psychological burden and quality of life (QoL) in caregivers of pediatric patients with nephropathic cystinosis, a severe chronic disease. This observational, single-center study aimed to explore the levels of anxiety, depression, care burden, and QoL status in caregivers of patients with nephropathic cystinosis. The Hospital Anxiety and Depression Scale (HADS), the Zarit Caregiver Burden Scale, and the Short Form-36 (SF-36) were administered to caregivers of pediatric patients with nephropathic cystinosis. Nine caregivers of pediatric patients with nephropathic cystinosis participated in the study (6 boys and 3 girls; mean age, 12.6 ± 4.2 years). All participating caregivers were the patient's mothers. Of the 9 caregivers, 6 showed anxiety/depression and 4 severe care burden. Overall, SF-36 QoL domains with a worse perception by caregivers were 'general health' and 'health change over time'. Mothers without depression/anxiety and low care burden had better QoL perception (p = 0.02). All caregivers with high care burden showed anxiety/depression. In our study cohort, caregivers of pediatric patients with nephropathic cystinosis showed high levels of anxiety/depression, high care burden, and impaired QoL, highlighting the importance of detecting psycho-social issues to implement strategies that relieve family stress and improve coping strategies.

Psychosocial Dimensions of Pain Disparities in Youth Diagnosed with Unspecified Abdominal Pain in an Emergency Department

Diagnosis ambiguity, paired with pain care inequities experienced by marginalized groups may increase risk for ongoing pain and impairment in children diagnosed with unspecified abdominal pain in the pediatric emergency department (PED). This cross-sectional study examined psychological, caregiver, cultural, and socio-ecological factors associated with pain-related impairment in an ethnically and socioeconomically diverse population diagnosed with unspecified abdominal pain in a PED. The sample included 111 children 8-17 years old (59.8% female, 72.7% Latinx) and their caregivers. Exclusion criteria included an Emergency Severity Index <2, psychiatric complaint, or not fluent in English or Spanish. Children completed the PROMIS Pain Interference Scale and reported pain intensity, pain duration, and pain catastrophizing. Caregivers reported language preference, pain catastrophizing, trait anxiety, and child internalizing symptoms. Area Deprivation Index quantified socio-ecological deprivation according to 9-digit zip code. Multivariable logistic regression analyses identified independent associations with likelihood of reporting severe levels of pain-related impairment. Approximately 35.3% of children reported severe levels of pain-related impairment. In logistic regression analysis, an increased likelihood of endorsing severe pain-related impairment was associated with pain for >1 month (OR=9.19, p=.044), higher child pain catastrophizing (OR=1.23, p<.001), caregiver Spanish language (OR=11.11, p=.044), and clinically significant caregiver trait anxiety (OR=58.16, p=.004). Results highlight the incidence of severe pain-related impairment in children diagnosed with unspecified abdominal pain in a PED. Moreover, findings underscore the importance of screening pain-related impairment and caregiver anxiety, and addressing language barriers in this PED population. PerspectiveThis paper highlights the incidence of severe pain-related impairment among pediatric patients diagnosed with unspecified abdominal pain in a pediatric emergency department (PED). Results could inform early assessment and targeted interventions in the PED to prevent outcome disparities.

The Role of Perceived Social Support on Stress, Anxiety, Depression and Care Burden Levels of Caregivers of Cancer Patients: A Turkish Republic of Northern Cyprus (TRNC) Example.

The current study investigated the role of perceived social support in the relationship between stress, depression, anxiety, and caregiving burden on caregivers of cancer patients. The research was conducted in the Turkish Republic of Northern Cyprus. In this sense, the situation in a region that is not often subject to research is reflected in the literature. In the current study, data from 93 caregivers were examined. 61.6% of the participants are women and the mean age of the participants is 40.82. Sociodemographic Information Form, Zarit Caregiver Burden Scale, Multidimensional Scale of Perceived Social Support, Depression Anxiety Stress Scale were used as measurement tools. Caregivers' depression and anxiety levels were found to be normal, and their stress levels were found to be mild. Caregiving burden, depression, anxiety, stress, and perceived social support were found to be interrelated variables. Six models of the role of perceived social support were tested. The analysis results showed that perceived social support had a mediating role, but not a moderating role, in the relationships between stress and caregiving burden, depression and anxiety. This finding, which is not frequently encountered in the related literature, was discussed with the related literature and suggestions for future studies were presented in the light of the findings.

The Effect of Forgiveness Psychoeducation on Death Anxiety, Caregiver Burden, and Forgiveness Tendencies in Caregivers of Patients at the End of Life: A Randomized Controlled Trial.

Providing caregivers with the skills and awareness of forgiveness is crucial to help them express their emotions, navigate the grieving process more smoothly, enhance their interaction with the patient, and make the time until the patient's death more meaningful. To examine the effect of forgiveness psychoeducation on death anxiety, caregiver burden, and forgiveness tendencies in caregivers of patients at the end of life. A randomized controlled experimental method was used, including a pretest, posttest, 1-month follow-up, and 3-month follow-up. The research sample included 56 caregivers of patients (experimental group = 28, control group = 28) at the end of life. During the study, forgiveness psychoeducation was administered to the experimental group, whereas no intervention was carried out in the control group. Data were collected using the Personal Information Form, Thorson-Powell Death Anxiety Scale, Caregiver Burden Scale, and Heartland Forgiveness Scale. The average scores of death anxiety and caregiving burden in the posttest and follow-up measurements of caregivers in the experimental group were statistically significantly lower than those of caregivers in the control group (P < .05). Forgiveness psychoeducation reduces death anxiety and caregiving burdens in caregivers of patients at the end of life. It is recommended to provide psychoeducation on forgiveness. The psychoeducation conducted by Consultation Liaison Psychiatry Nurses aimed at increasing the internal process of forgiveness can positively influence the communication, emotions, and spiritual development of caregivers of patients at the end of life. Thus, improving the quality of care can be achieved through forgiveness.