Caregiver Characteristics Research Articles

Inter-reporter differences in symptom burdens in Japanese children with cancer.

Recent studies about inter-reporter differences and patient-reported outcomes (PROs) in childhood cancer from Western countries showed that caregiver proxy reports tend to overestimate symptom burdens in comparison with children's self-reports. However, the results from Western countries may not be generalizable to Asian countries. This paper is a secondary analysis of a validation study of the Japanese pediatric version of the Memorial Symptom Assessment Scale including 88 dyads of children aged 7-12 years and 74 dyads of children aged 13-18 years and their caregivers. The study assessed the inter-reporter differences of eight and 31 symptom burdens calculated as symptom scores in children aged 7-12 years and 13-18 years, respectively, and the association between inter-reporter differences and the characteristics of children and caregivers. The majority of children and caregivers scored equally at the dyadic level for almost all symptoms. However, 37.5% of symptoms in children aged 7-12 years and 10.0% of symptoms in children aged 13-18 years showed significant inter-reporter differences, suggesting a general tendency of caregivers to underestimate their children's symptom burden. The caregiver's age was the characteristic most frequently associated with magnitude of inter-reporter differences. Caregiver proxy reports may be a reliable source of PROs in Japanese children with cancer, as self-reported and caregiver proxy-reported symptom burdens were generally concordant. However, as some significant inter-reporter differences were observed, an effort should be made within the medical community to evaluate the parent-child relationship to minimize inter-reporter differences and achieve better symptom management.

Influence parental- and child-related factors on the acceptance of SARS-CoV-2 test methods in schools and daycare facilities.

Rapid testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections was an essential step in reducing the spread of the virus and monitoring pandemic development. Most mandatory standard pandemic testing in Germany has been performed in schools and daycare facilities. We investigated the influence of behavioral and attitudinal characteristics of children and caregivers on their acceptance of (i) antigen-based nasal swab rapid and (ii) oral saliva-based pooled Polymerase Chain Reaction (PCR) tests. Conducted through a cross-sectional survey between November and December 2021, with 1962 caregivers and 581 children/adolescents participating, the study evaluated the acceptability of each testing method on a six-point scale. Participants scored one test method conducted on their child at one of six levels with 1 and 6 denoting "excellent" (1) and "inadequate" (6), respectively. We considered demographic variables, vaccination status, child mental health (measured by the SDQ-questionnaire), and facility type (kindergarten, primary school, secondary school) as covariates. Results reveal a preference for saliva-based PCR tests over nasal swabs by about one grade, particularly among parents of unvaccinated children, especially if their child expressed future vaccination reluctance. Testing acceptance was lower among children with mental health issues, primary school-aged, and those with less-educated parents. Perception of test accuracy and convenience influenced attitudes, favoring saliva-based PCR tests. Moreover, children with mental health issues felt less secure during testing. To our knowledge, this is the first study to investigate the influence of different testing methods on testing acceptance for SARS-CoV-2 in children and caregivers. Our study identifies predictors of lower acceptance of public health surveillance measures and enables the development of educational programs on testing and vaccination tailored to the needs of specific target groups. Moreover, we demonstrate that test acceptance in vulnerable groups can be enhanced by careful choice of an appropriate testing method.

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.

뇌졸중 환자 가족돌봄제공자의 일반적 특성과 보호자의 심리적 요인간의 상관관계

Objective : The role of family caregivers is a very important factor in the patient's recovery. In this study, based on these previous studies, we confirmed the correlation between the general characteristics of family caregivers of stroke patients and psychological factors. Through this, we would like to suggest a method of supporting the caregiving behavior of family caregivers. Methods : This study conducted a paper questionnaire and an online survey targeting 112 family caregivers who are currently caring for their family members. The research period was conducted for 4 weeks from September 30 to October 30, 2023. Descriptive statistics were obtained for the data collected through the questionnaire using spss 23.0 for Windows, and multiple regression analysis was performed to see the correlation between the general characteristics of family caregivers and psychological factors. Results : First, in the caregiver response scale according to general characteristics, there was a relationship between gender, disease period, and age of the family caregiver. Second, the burden of care according to general characteristics was related to gender, disease period, age of family caregiver, place of care, and personal insurance. Third, in terms of stress coping strategies according to general characteristics, there was a relationship between the age of the family caregiver, location&#x0D; of care, and employment of personal care. Fourth, gender, onset period, and age of family caregiver were related to depression according to general characteristics. Conclusion : In this study, we sought to identify independent variables that can be influenced by environmental&#x0D; changes in family caregivers. Support methods that enable changes in the environment, such as location of care, personal insurance, and employment of personal caregivers, were presented to those who provide family caregivers.

Anxiety and depression in family caregivers of hemodialysis patients: Incidence, risk factors, and correlation

Background: Chronic kidney disease (CKD) imposes a significant global burden, with diabetes and hypertension being major contributors. In the severe stage, CKD patients require long-term hemodialysis (HD) treatment and rely on family caregivers for support. Caregivers often experience mental health challenges, including anxiety and depression, which can impact their quality of life and patient outcomes.Objective: This study aimed to identify the anxiety and depression incidence in HD family caregivers at Soehadi Prijonegoro Regional Public Hospital (SPRPH), identify the risk factors associated with these conditions, and investigate the relationship between anxiety and depressionMethods: A cross-sectional analysis was carried out at the Hemodialysis Department from November 2022 to February 2023. Caregivers accompanying CKD patients undergoing HD participated voluntarily. Anxiety and depression levels were evaluated using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Results: Out of 106 participants, 66% were female. Most caregivers (99%) experienced anxiety, with 91% classified as mild and 8% as mild to moderate. Depression was reported by 42%, with 2% experiencing mild to moderate symptoms. Spearman’s analysis revealed a significant correlation between anxiety and depression (p=0.000). No specific caregiver characteristics were found to be associated with anxiety or depression.Conclusion: Family caregivers of HD patients demonstrated a high incidence of anxiety and a lower prevalence of depression. Anxiety levels were correlated with depression levels. We did not identify specific risk factors for these mental health conditions among caregivers. These findings emphasize the need for mental health screening and appropriate management to improve the quality of life for HD family caregivers.

The personality traits of family caregivers of individuals with dementia: The effects of social anxiety, social phobia, and caregiving hours

Background and Aim of Study: Caring for individuals afflicted with dementia engenders substantial demands and responsibilities for caregivers, encompassing the extensive time allocation devoted to the care recipient on a daily basis. Furthermore, the psychological attributes inherent in informal caregivers, encompassing traits like social anxiety and social phobia, can exert an influence on the evolution of their personal dynamics over time. This phenomenon potentially yields repercussions for how caregivers offer guidance and assistance to elderly individuals grappling with dementia, particularly in relation to their fundamental daily activities and instrumental tasks. The aim of the study: to analyze the predictive effect of social anxiety and social phobia as psychological characteristics of caregivers, along with the impact of caregiving hours as caregiving-related characteristics, on caregivers’ personality. Material and Methods: This observational and cross-sectional study comprised a sample of 97 participants serving as primary family caregivers completed a sociodemographic questionnaire, the Big Five Inventory, the Anxiety Scale in Social Interaction Situations, and the Social Phobia Scale. Results: The findings revealed that social phobia demonstrated significant predictive power for Openness (β=-0.199; p=0.016) and Extraversion (β=-0.136; p=0.024), whereas the daily caregiving hours negatively affected Conscientiousness (β=-0.145; p=0.011), Agreeableness (β=-0.137; p=0.040), Openness (β=-0.210; p=0.011), and Extraversion (β=-0.175; p=0.003). Conversely, social anxiety did not prove to be a significant variable. Conclusions: The presence of social phobia or higher hours devoted to caregiving for individuals with dementia are factors that impact personality functioning and should be considered in the planning of support programs for family caregivers.

SPOUSAL CAREGIVING AND PARALLEL COGNITIVE TRAJECTORIES AMONG OLDER ADULT CAREGIVERS AND RECIPIENTS IN CHINA

Abstract Prior studies have paid much attention to the physical and mental health outcomes of spouse caregivers. However, few have looked at the cognitive trajectory of caregivers and how it was associated with the characteristics of caregivers and care recipients. Based on four waves (2011, 2013, 2015, and 2018) of the Chinese Health and Retirement Longitudinal Survey (CHARLS) (N=3137 dyad couples aged 45 and above), cognitive function was measured by Mini-Mental State Examination (MMSE). A parallel process growth model was conducted to explore the association between spouse caregiving and the joint trajectories of caregivers and their recipients’ cognitive decline during the eight years. Preliminary results show that 1) couples’ trajectories are significantly related to each other, although men had a higher initial level of cognitive function than women, their cognitive function declined at a faster rate than women did; 2) The relationship between caregiving and cognitive trajectory varies by gender. Specifically, providing care is positively correlated with slower cognitive decline in men, but not in women. Whereas receiving the care was associated with a faster cognitive decline for both gender. These findings emphasize the need of paying attention to both family caregivers and recipients and the need for more targeted intervention strategies based on the nature of care.

EXAMINING DIFFERENCES IN SLEEP QUALITY AMONG CAREGIVERS FOR PERSONS LIVING WITH AND WITHOUT DEMENTIA

Abstract Sleep disturbances among caregivers are linked to increased burden and worse mental health outcomes. Caregivers for persons living with dementia experience more sleep disturbances than non-caregivers. Few studies examine whether sleep quality differs between dementia and non-dementia caregivers. This study analyzes whether dementia caregivers experience worse sleep quality than non-dementia caregivers. Using 2017 National Study of Caregiving, National Health and Aging Trends Study, and time diary interview data, we examined the relationship between caregiver sleep quality (“excellent/very good” versus “good/fair/poor” the previous night) and care recipient’s dementia status (“probable” versus “no”) for 1,374 caregivers in a series of nested multi-variable logistic regression models, controlling for the caregiver and care recipient sociodemographic characteristics, relationship quality, and other controls. Caregivers’ mean age was 62.3 years old (SD=14) and about two-thirds were women (68%), non-Hispanic White (69.4%), and married (66%) Thirty-eight percent cared for persons living with dementia. In the bivariate model, being a caregiver for someone living with dementia was associated with significantly lower odds of reporting “excellent/very good” sleep quality (OR: 0.78, 95%CI: 0.62-0.97, p=0.02). This relationship persisted independent of caregiver and care recipient demographic characteristics. However, caregiver perceptions of the quality of their relationship with the care recipient and the benefits of their caregiving role explained the relationship between care recipient dementia status and caregiver sleep quality ratings (AOR: 0.80, 95%CI: 0.63-1.02, p=0.08). Addressing caregiver burden and relationship quality may help improve sleep quality among dementia caregivers and reduce disparities in sleep quality between dementia and non-dementia caregivers.

FAMILY CAREGIVERS AT WORK: THE RELATIONSHIP BETWEEN WORK PRODUCTIVITY LOSS AND WORKPLACE SUPPORTIVE MEASURES

Abstract Background Employment and economic security remain elusive for the majority of working family caregivers, especially for caregivers for older adults with complex health problems. Family paid leave remains unattainable in the United States requiring caregivers to work while providing critical support to older adults making them vulnerable for unemployment and financial hardships. While caregivers experience higher rates of absenteeism and presenteeism at work compared to their non-caregiving counterparts, research pertaining to the impact of supportive measures in the workplace is relatively unknown. Methods This exploratory, cross-sectional study examined 1) the relationship between supportive workplace measures (i.e., employment stability, flexible work schedules), and productivity loss, absenteeism and presenteeism; and 2) the relationship between caregiver characteristics (i.e., traditional versus non-traditional) and supportive workplace measures, productivity loss, absenteeism, and presenteeism. Data from 2017 (n=2,652) and 2020 (n=1,938) waves of the National Survey of Caregivers (NSOC) were analyzed using the validated WPAI-CG measure. Results Bivariate findings suggest an association between workplace flexibility and productivity loss (p&amp;lt;.001), absenteeism (p&amp;lt;.001), and presenteeism (p&amp;lt;.001); caregivers with flexible hours had greater productivity loss, absenteeism, and presenteeism compared to caregivers without flexible hours. Additionally, caregivers in traditional dyads reported higher work productivity loss (p&amp;lt;.001) and presenteeism (p&amp;lt;.001) compared to non-traditional dyads. Conclusions Findings suggest flexible hours may not adequately address workplace issues experienced by family caregivers for older adults. As the number of older adults increases over the next decade, greater understanding of the best way to decrease work challenges for diverse caregivers is critical.

DO PUBLIC HOME CARE CLIENTS “LOSE OUT ON SERVICES” BECAUSE THEY HAVE A FAMILY CAREGIVER?

Abstract The public home care (PHC) system in Canada is heavily reliant on family caregivers to enable clients to stay in the community. When caregivers are present, there are concerns formal home care aide (HCA) services are less available. Using data from the Resident Assessment Instrument for Home Care (RAI-HC), we examined caregiver and client characteristics in relation to HCA service amounts. Our cohorts were individuals aged 60+ receiving an initial RAI-HC assessment in 2011-2013, and one subsequent assessment in two provincial jurisdictions: the Winnipeg Regional Health Authority (n=5,251) and Nova Scotia Health (n=5291). We measured weekly HCA hours and constructed a predictive model for hours of care controlling for client need. To identify the most underserved client population, we calculated the ratio between predicted to actual received hours of care ascertaining the lowest client quintile. In both jurisdictions, the odds of being underserviced were higher when the client co-resided or had a spouse. Clients living alone at initial intake were least likely to be underserved. Caregiver characteristics increasing the risk of being underserved in Winnipeg included providing IADLs/ADLs support, caring more than 14 hours per week and being unable to continue. Rurality increased risk of underservice in Nova Scotia. These findings contribute to the debate: is PHC a supplement or substitution for family care? PHC as a supplement to family care was more pronounced in Winnipeg and in rural Nova Scotia. Implications for greater equity across regions is explored using an Equity, Diversity and Inclusion lens.

ONLINE MEDICAL RECORD (OMR) USE IN CAREGIVERS OF PEOPLE WITH DEMENTIA IN THE UNITED STATES

Abstract Objective Studies have found that there are higher levels of stress among informal caregivers of individuals with dementia. As a result, it is important to seek ways to reduce their burden. Online Medical Records (OMRs), often referred to as patient portals, provide effective communication tools to caregivers and the use of OMRs have been found to have the potential to ease their stress levels. This study examined OMR usage in informal caregivers of people with dementia and identified factors that were associated with their usage. Methods Data came from the HINTS, a National Cancer Institute (NCI)-sponsored survey of American adults. We merged data from HINTS 5 cycles 2, 3, and 4 administered between 2018 and 2020 into 1 data set. Our analytical sample included a total of 304 informal caregivers of people with Alzheimer’s disease. The outcome variable was OMR use in the last 12 months, and independent variables included age, sex, race and ethnicity, education, household income, marital status, employment status, relationship to care recipient, and the number of chronic conditions. Data was analyzed using multivariate logistic regression. Results 53% of caregivers have used OMRs at least once in the past 12 months. Caregivers with a higher level of education and greater number of chronic conditions are more likely to have used OMRs. Conclusion Being able to access OMRs could reduce caregiver stress. There are certain caregiver characteristics that increase the likelihood of them utilizing this resource. Targeted approaches may be necessary to increase the range of use.

INTERPLAY OF COGNITIVE STATUS AND SPOUSAL CAREGIVER PATTERNS ON WELL-BEING

Abstract The current paper investigated the intersection of cognitive status and caregiver characteristics on older adults’ reports of life satisfaction and depressive symptoms. Using a sub-sample from the 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol (HRS-HCAP), individuals were selected if the HCAP informant was a spouse self-identified caregiver. The sample was trimmed to include those whose spouse caregiver was also a respondent in the main 2016 HRS and completed the measures of interest in the psychosocial leave-behind questionnaire (N = 190). The final analytic sample comprised 109 respondents classified as cognitively normal, 51 with cognitive impairment, not dementia, and 30 with dementia based on the algorithm developed by Manly, Jones, Langa, et al. (2022). The sample was 50% women, 10% racialized as Black, 18% racialized as LatinX, with a mean age of 75.62 and an average 11.75 years of education. Latent Class Analysis identified meaningful caregiver psychosocial classes from spouse reports on purpose in life (Ryff &amp; Keyes, 1995), positive and negative affect (Watson &amp; Clark, 1994), and perceived positive and negative support from one’s spouse (in this case the main respondent), children, other family, and friends (Turner, Frankel, &amp; Levin, 1983). The data supported a 4-class solution, which was then used in linear regression analyses to examine associations of cognitive status and caregiver profiles on individual’s life satisfaction and depressive symptoms. Interestingly, cognitive status was not associated with well-being in the current study, suggesting associations of spousal psychosocial classes were independent of the care-recipient’s dementia/impairment designation.

ASSOCIATION OF BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA WITH ADVERSE OUTCOMES POSTHOSPITALIZATION

Abstract In hospitalized persons with dementia, behavioral and psychological symptoms of dementia (BPSD), also known as behavioral symptoms of distress, are associated with increased morbidity, long-term care admissions, and reduced care partner well-being. The Fam-FFC study provided the opportunity to examine the association between BPSD severity and adverse, post-acute outcomes (falls, emergency department transfers, hospital admissions). Logistic regression analysis examined the association of behavioral symptoms (Neuropsychiatric Inventory Questionnaire, NPI) and odds of having a fall, emergency department transfer, and hospital admission, controlling for the intervention, and caregiver and patient characteristics. NPI scores decreased from admission (M = 7.81, SD = 6.12), to discharge (M = 6.4, SD = 5.93), to two months (M = 5.38, SD = 5.91), to six-month follow-up (M = 5.08, SD = 5.94). Higher admission NPI scores were associated with greater odds of experiencing at least one fall (OR = 1.067, p = 0.042) by discharge. Higher discharge NPI scores were associated with higher odds of ED transfer (OR = 1.062, p = 0.006) and at least one hospitalization (OR = 1.06, p = 0.008) after two months. Higher NPI scores at 2-month follow-up were associated with increased odds of ED transfer (OR = 1.062, p = 0.004), experiencing at least one injury (OR = 1.055, p = 0.031), falls (OR = 1.056, p = 0.012), and hospitalizations (OR = 1.065, p = 0.004) at six months. Results underscore the importance of providing interventions to reduce BPSD as a potentially modifiable risk factor to reduce adverse outcomes.

EFFECT OF A COVID-19-RELATED LOCKDOWN ON MIDDLE-AGED AND OLDER FAMILY CAREGIVERS IN SINGAPORE

Abstract Lockdowns, while limiting COVID-19 transmission, can affect care provision by family caregivers and their caregiving experience. We assessed, among 1094 family caregivers aged 50-79 years in Singapore, the (1) perceived effect of nationwide lockdown on their care provision, (2) correlates of different perceptions, and (3) association of the perceptions with negative and positive caregiving experiences. Caregivers reported whether their care provision became harder, easier, or remained the same during versus before the lockdown. Multinomial logistic regression assessed the association of caregiver, care-recipient, and caregiving-context characteristics with their perceptions. Linear regression models examined the association of their perceptions with subsequent negative and positive caregiving experiences. Care provision became harder for 36%, easier for 18% and remained the same for 46% caregivers. Care provision becoming harder (versus same) was more likely for caregivers who were male, Chinese, in worse health, caring for care-recipients with functional limitations, without caregiving support from cohabiting family before the lockdown, and with caregiving support from non-cohabiting family before the lockdown. Care provision becoming easier (versus same) was less likely among caregivers who were of higher age, unemployed, socially isolated and whose care-recipients had functional limitations. Caregivers for whom care provision became harder were worse off in negative caregiving experiences. A nationwide lockdown did not make care provision harder for all caregivers. However, those for whom it did had greater negative caregiving experiences. Heterogeneity of the effect of lockdowns and offering flexibility to non-cohabiting family who support caregiving should be considerations when implementing such disruptions.

CORRELATES OF DENTAL CARE UTILIZATION AMONG US INFORMAL DEMENTIA CAREGIVERS

Abstract Informal dementia caregivers tend to report more negative health impacts from the caregiving role, higher levels of unmet needs, and lower levels of service utilization compared to caregivers of persons with other types of illnesses. There remains a gap in knowledge of understanding unique correlates of dental care utilization among informal dementia caregivers. As guided by the Andersen model, this study examined correlates of dental care utilization among U.S. informal dementia caregivers. Data came from the Behavioral Risk Factor Surveillance System collected in 2016, 2018, and 2020 (n=2,931). Respondents were selected when they reported providing regular care or assistance to a friend or family member who has Alzheimer’s disease, dementia, or other cognitive impairment disorder. Dental care utilization was dichotomized into “yes” versus “no” within the past year. Caregiving-related characteristics included caregiver role (e.g., spouse, adult child, other relative, and friend), intensity of care, duration of care, and type of care. Other correlates included caregiver characteristics, health behaviors, and physical and oral health needs. Findings from stepwise logistic regression models demonstrate that being a spousal caregiver, providing more than 20 hours of care per week, being male, having high school or less education, being low-income, unemployed, current smoker, having no health insurance, no current alcohol use, or less than adequate sleep was associated with a lower likelihood of vising a dentist within the past year. The findings suggest targeting spousal caregivers and those who provide intensive care to improve dental care-seeking behaviors in dementia caregiver support intervention strategies.

An examination of characteristics, social supports, caregiver resilience and hospital readmissions of children with medical complexity.

Children with medical complexity (CMC) account for 1% of children in the United States. These children experience frequent hospital readmissions, high healthcare costs and poor health outcomes. A link between CMC caregiver social support, resilience and hospital readmissions has never been fully investigated. This study examines the feasibility of a prospective, descriptive, repeated measures research design to characterize CMC and their caregivers, social supports, caregiver resilience and hospital readmissions to inform a larger prospective investigation. Caregivers of CMC with unplanned hospitalizations completed surveys at the index hospitalization and 30 and 60 days after discharge. CMC caregiver and child characteristics, social supports and hospital readmissions were examined using an investigator-developed survey. Resilience was measured using the Resilience Scale-14© (7-Point Likert Scale, score range 14-98), and feasibility was measured by calculating enrolment, attrition, survey completion and item response. Analysis included descriptive statistics and qualitative data visualization. Of caregivers who were approached for participation, 81.1% consented and completed 76 surveys. Attrition was 31%. Item response rates were ≥ 90% for all but one item. A total of 62.1% of children had hospital readmissions within 90 days and 37.9% within 30 days. Additionally,70% of caregivers had home care nursing, but the approved hours were only partially filled. More than 70% of caregiver resilience scores were moderate to high (score range 74-98) and were stable across repeated measures and hospital readmissions. Open-ended question responses revealed the following five categories: All-consuming, Family Reliance, Impact of Covid, Taking Action and Broken System. Studying CMC caregiver social supports and resilience using repeated measures is feasible. CMC caregivers reported stressors including coordinating their child's substantial healthcare needs and managing partially filled home care nursing hours. Caregiver resilience remained stable over time, amidst frequent CMC hospital readmissions. Findings can inform future research priorities and power analyses for CMC caregiver resilience.

Prioritizing intervention preferences to potentially reduce caregiver burden in racially and ethnically diverse close family members of cardiac arrest survivors

AimClose family members of cardiac arrest patients who survive to hospital discharge have elevated levels of psychological distress and caregiver burden. We assessed their preferences toward needs during hospitalization and beyond to inform intervention development. MethodsThrough an online survey developed by a multidisciplinary team of researchers, clinicians, cardiac arrest survivors, and families, adult close family members recruited through advocacy organizations ranked top choice among 8 unique interventions addressing either information-based needs (n = 4) or well-being needs (n = 4). Logistic Regression analysis was conducted to assess the associations of family members’ attributes, caregiving characteristics, and survivors’ hospitalization factors with two intervention groups. ResultsOf 657 responses received, ranking data of 550 close family members (59% between 18–40 years of age, 65% female, 51% of minority race/ethnicity, 53% partners, provided a median of 8 hours of caregiving, for a median of 4.5 months) were analyzed. Information needs were the more commonly preferred intervention group (63%; n = 347), with education on the potential recovery of survivors ranking first (28%; n = 149). In a multivariate model, family members age >40 years, families witnessing the cardiac arrest, assuming the caregiver role either during hospitalization or within one month of hospital discharge, and discharging directly to home were significantly associated with prioritizing information needs over well-being needs, after adjusting for sex, race, intensity, and duration of caregiving. ConclusionsInterventions focusing on information needs are among the top priorities for families of cardiac arrest survivors. Prospective studies testing these hypotheses-generating findings are needed to inform further intervention development.

Enhancing caregivers self-management for their children who require medical technology: A feasibility study for the COPE-STAR intervention

PurposeTo test feasibility of the Creating Opportunities for Personal Empowerment: Symptom and Technology Management Resources intervention for caregivers of children who require medical technologies of tracheostomies and feeding tubes. Design and methodsQuasi-experimental one group design with measures at baseline and at 4 weeks. Intervention feasibility was tested from August 2019–June 2021, including recruitment, retention, and adherence, and caregiver satisfaction. Caregiver and child characteristics and outcomes were assessed. ResultsCaregivers were enrolled (n = 22) and completed (n = 16) the study. Caregivers were primarily female (n = 21), were predominately Caucasian (n = 14, 64%) followed by African-American (n = 8, 36%), and Non-Hispanic/Latino (n = 18, 82%). Feasibility indicators of recruitment (92%), retention (73%), and adherence (100%) were satisfactory. Outcome measures of management of child's chronic condition, caregiver beliefs about managing their child's symptoms and medical technology, anxiety, and depressive symptoms remained stable. Caregivers agreed that the intervention was useful, easy to use, and acceptable, and had positive feedback. ConclusionsThis is a feasible and acceptable intervention. With further development and efficacy testing, the intervention has potential for use and expansion to a larger population of caregivers of children who require medical technology. Practice implicationsChildren who require medical technology have multiple complex chronic conditions and complex care needs at home. This intensive and focused care is provided by informal caregivers who need education and resources for their child's care. This intervention addressed caregiver management of common symptoms and medical technologies of children in the home setting.

Dyadic influences on awareness of condition in people with dementia: findings from the IDEAL cohort.

The discrepancy between caregiver-ratings and self-ratings of abilities is commonly used to assess awareness in people with dementia. We investigated the contribution of caregiver and dyadic characteristics to the difference in perspective between caregiver-informants and people with dementia about difficulties experienced, when considering awareness of condition. We conducted exploratory cross-sectional analyses using data from the IDEAL cohort. Participants were 1,038 community-dwelling people with mild-to-moderate dementia, and coresident spouse/partner caregivers. The Representations and Adjustment to Dementia Index (RADIX) checklist reporting difficulties commonly experienced in dementia was completed by 960 caregiver-informants and 989 people with dementia. Difference in scores was calculated for 916 dyads. Demographic information, cognition, informant-rated functional ability and neuropsychiatric symptoms were recorded for the person with dementia. Self-reported data were collected on mood, comorbidity, religion, importance of religion, relationship quality, and caregiver stress. For most dyads, caregivers reported more RADIX difficulties than people with dementia. Caregiver RADIX ratings were more closely associated with informant-rated functional ability and neuropsychiatric symptoms than with cognition. More RADIX difficulties and higher stress were reported by female caregivers. Greater RADIX difference was associated with more caregiver stress, and older age but less depression in people with dementia. Few dyadic characteristics were important, but caregiver stress was higher where caregivers reported more RADIX difficulties and/or the difference in perspective was greater, whereas partners with dementia reported better mood. In addition to offering information about awareness of condition, the caregiver rating and difference in perspectives could indicate where more support is needed.

Swipe, tap, read? Unveiling the effects of Touchscreen devices on Emergent Literacy Development in preschoolers

Emergent literacy skills are vital for children’s reading and writing development. While touchscreen devices have been linked to enhanced emergent literacy in developed countries, their impact in low- and middle-income countries (LMICs), with limited access to quality apps, is underexplored. Thailand, classified as an upper-middle-income country, presents a unique context with its specific challenges in educational technology, which have not been extensively studied. This study examined the relationship between touchscreen device usage and emergent literacy development in Thai preschool children. Using a cross-sectional design, we analyzed data from 317 Thai children aged 5–6 years, assessing their emergent literacy skills and examining the association with touchscreen device usage through logistic regression analysis. Our findings showed that 79.5% of participants engaged with touchscreen devices, and there was an observed trend suggesting that exclusive tablet users might exhibit enhanced phonological awareness, letter naming, and rapid automatized naming skills. However, these potential improvements did not reach statistical significance when primary caregiver characteristics were taken into account. Our findings highlight the complexity of this relationship and underscore the need for further research to elucidate the potential influences of application quality and screen time engagement on emergent literacy, particularly in LMICs.