Caregivers Of Dementia Patients Research Articles

Spirituality and Self-Efficacy in Caregivers of Patients with Neurodegenerative Disorders: An Overview of Spiritual Coping Styles

The objective of this research was to assess the effect of spirituality and self-efficacy in the mental health of caregivers of patients with neurodegenerative disorders. Four styles of spiritual coping were examined to identify which of them can function as protective or risk factors for caregivers of patients with neurodegenerative disorders. Interviews were conducted face-to-face to 116 caregivers of patients diagnosed with some type of neurodegenerative disorder. The results showed that caregivers with a selfless spiritual coping style exhibit significantly higher depression, stress, and perceived overload than those with a collaborative style. No statistically significant differences were found between the means of the other styles of spiritual coping. Simultaneously, it was found that the selfless spiritual coping style is a risk factor for overload, depression, and stress. The study is a first step in understanding how spirituality interacts with self-efficacy to protect the mental health of caregivers of dementia patients in Puerto Rico. Our results theoretically and empirically support the functional compatibility of both psychological resources.

A Causal Model of Caregiving Burden among Dementia Caregivers

In this study, a cross-sectional, predictive correlation design was used to identify and test a causal relationship between behavior disturbances, coping, family conflict, self-esteem and social support to caregiver burden among dementia caregivers. A total of 450 caregivers of dementia aged over 18 years were recruited from 4 hospitals in northern Thailand based on selected criteria. Demographic Questionnaire, Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD, The Family Conflict Scale, The Zarit Burden Interview Scale, The Perceived Social Support Questionnaire, The Brief COPE and The Rosenberg Self-Esteem with acceptable reliability coefficients were used to collect data. Data were analyzed using descriptive statistics, Pearson’s Product-Moment Correlation and path analysis by structural equation modeling.
 Results showed that the modified model fitted with the data and explained 58 % of the variance in caregiving burden among dementia caregivers. Coping and family conflict had a positive direct effect on caregiving burden (p < 0.001), whereas self-esteem and social support had a direct negative effect on caregiving burden (p < 0.001). Behavior disturbance had a positive indirect effect caregiving burden (p < 0.001) via family conflict. Coping had a positive indirect effect on caregiving burden (p < 0.001) via behavior disturbance and family conflict. Social support had a negative indirect effect on caregiving burden (p < 0.001) via family conflict and self-esteem. The results of this study could be used as a guideline for psychiatric nurses in planning an appropriate intervention program to reduce burden of caregivers of dementia patients in Thailand.

An intervention programme for caregivers of dementia patients with frontal behavioural changes: an explorative study with controlled effect on sense of competence.

Caregivers of dementia patients experience high levels of burden; this is especially true of caregivers of dementia patients with behavioural problems. As intervention studies for these caregivers are still lacking, we conducted an explorative pilot study into the efficacy of a support programme. Participants were caregivers of dementia patients affected by apathy, disinhibition, and/or stereotypical behaviour. All patients had a Frontal Behavioural Inventory score of 11 or higher. Caregivers were randomized to the intervention group or control group (both n = 15). The intervention was a 6-month programme that consisted of psychoeducation, social support, and behavioural cognitive therapy. Quantitative and qualitative data were collected at baseline and after the intervention. An increased sense of competence was found in the intervention group. Burden, perceived stress, and depressive symptoms decreased, although the difference between the intervention and control groups was not significant. Caregivers' sense of competence improved as a result of the support programme, and caregivers revealed its comprehensive supportive effects. Further research into the efficacy of the programme on a larger scale is recommended.

Caregivers' education decreases depression symptoms and burden in caregivers of patients with dementia.

To determine whether providing education to caregivers of patients with dementia decreases their depression symptoms and burden. Eighty-three outpatients with dementia being treated at the Memory Clinic of Tokyo Medical University Hospital and their caregivers were enrolled. Forty-seven caregivers were enrolled in the caregivers' education (EDU) group and 36 were enrolled in the control (CTL) group. Caregivers were assessed for depression, burden, and quality of life (QoL). Patients were assessed for cognition, psychological symptoms, and QoL. Assessments were carried out at baseline and at 3 months (3M). Caregivers in the EDU group received lectures on symptoms and progression of dementia, management of symptoms, use of social resources etc. RESULTS: At 3M, prevalence of depression symptoms in the EDU group significantly decreased from 36% to 17%, whereas it significantly increased from 22% to 50% in the CTL group. Depression and burden were significantly improved at 3M in the EDU group, whereas they significantly worsened in the CTL group. Psychological symptoms showed a lower tendency at 3M for the EDU group. No significant changes in QoL of caregivers and patients were found in either group. Providing education to caregivers of patients with dementia improves their depression symptoms and sense of burden, and tends to improve the behaviour and psychological symptoms of dementia in the patients. Providing education to caregivers of dementia patients may hence result in beneficial effects for both the patients and their caregivers, and should be widely used in dementia care.

Predictors of potentially harmful behaviour by family caregivers towards patients treated for behavioural and psychological symptoms of dementia in Japan.

Potentially harmful behaviour (PHB) by caregivers is detrimental to the physical and psychological well-being of care recipients. In Japan, few studies have investigated caregivers' PHB towards dementia patients. This study examined PHB in family caregivers of dementia patients with behavioural and psychological symptoms of dementia (BPSD) and identified factors related to PHB. Following primary consultations at an elderly psychiatric patient department, we enrolled 133 pairs of dementia patients and their family caregivers. We assessed PHB using the Japanese version of the modified Conflict Tactics Scale. We defined the presence of PHB as two or more points (PHB frequency of 'sometimes' or more) on at least one indicator of the modified Conflict Tactics Scale. We investigated the prevalence of PHB in relation to the clinical characteristics of the patients and their family caregivers. We evaluated BPSD using the Neuropsychiatric Inventory and caregiver burden using the eight-item Japanese version of the Zarit Caregiver Burden Interview. Of the family caregivers, 48.9% showed PHB. Multivariate analysis identified the following association with PHB: caregiver's Zarit Caregiver Burden Interview total score (odds ratio [OR], 1.09 per unit increase; 95% confidence interval [95%CI], 1.02-1.16), and Neuropsychiatric Inventory scores for patient irritability (OR, 1.22 per unit increase; 95%CI, 1.06-1.40), appetite/eating disorders (OR, 1.41 per unit increase; 95%CI = 1.08-1.84) and daughters-in-law caregivers (OR, 0.17, 95%CI, 0.05-0.57). Specific BPSD symptoms could contribute to the expression of PHB. In addition to decreasing caregiver burden, more intensive treatment and care strategies are required to manage individual symptoms.

Burden and Strain among Familial Caregivers of Patients with Dementia in China

ABSTRACTBackground: Alzheimer's disease is one of a variety of progressive and ultimately fatal neurodegenerative diseases that are characterized by a number of nervous and mental symptoms and behavior disorders. These problems are likely to cause burden and strain on caregivers. In this study, we demonstrated the level and relationship of burden and strain among caregivers of dementia patients in China. Methods: A total of 212 caregivers of family members with dementia responded to the survey. A 22-item of the Zarit Burden Interview and a 13-item Caregiver Strain Index (CSI) were used. Results: The results showed that women comprised 88.2% of caregivers, and 58.5% of caregivers reported a level of medium burden. Over one-half of the caregivers reported a level of high strain, with the low income group being more likely to have high levels of burden and strain. Conclusion: Chinese familial caregivers of patients with dementia experience a moderate level of burden and a high level of strain. The main strain factors that affected the burden were changes in personal plans, time demands, and emotional adjustment.

Caregiver Burden in Semantic Dementia with Right- and Left-Sided Predominant Cerebral Atrophy and in Behavioral-Variant Frontotemporal Dementia

Background: Caregiver burden is a serious concern for family caregivers of dementia patients, but its nature is unclear in patients with semantic dementia (SD). This study aimed to clarify caregiver burden for right- (R > L) and left-sided (L > R) predominant SD versus behavioral-variant frontotemporal dementia (bvFTD) patients. Methods: Using the Japanese version of the Zarit Burden Interview (ZBI) and the Neuropsychiatric Inventory, we examined caregiver burden and behavioral and psychological symptoms of dementia (BPSD) in 43 first-visit outpatient/family caregiver dyads (bvFTD, 20 dyads; SD [L > R], 13 dyads; SD [R > L], 10 dyads). Results: We found a significant difference in ZBI score between the 3 diagnostic groups. Post hoc tests revealed a significantly higher ZBI score in the bvFTD than in the SD (L > R) group. The ZBI scores in the SD (L > R) and SD (R > L) groups were not significantly different, although the effect size was large. Caregiver burden was significantly correlated with BPSD scores in all groups and was correlated with activities of daily living and instrumental activities of daily living decline in the bvFTD and SD (R > L) groups. Conclusion: Caregiver burden was highest in the bvFTD group, comparatively high in the SD (R > L) group, and lowest in the SD (L > R) group. Adequate support and intervention for caregivers should be tailored to differences in caregiver burden between these patient groups.

Cognitive Behavioral Therapy for Depression, Anxiety, and Stress in Caregivers of Dementia Patients: A Systematic Review and Meta-Analysis.

There is limited evidence for the efficacy of cognitive behavioral therapy (CBT) in managing psychological morbidities in caregivers of dementia patients. To evaluate changes in dementia caregivers' depression, anxiety, and stress following CBT. Also to assess quality of life, intervention adherence/satisfaction and therapy effectiveness using different formats, frequencies, and delivery methods. Studies were identified through electronic bibliographic searches (MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Library) and from gray literature (Conference Proceedings Citation Index and clinicaltrials.gov). Data were pooled for meta-analysis. Twenty-five studies were included. Depression (standardized mean difference [SMD] = -0.34; 95% confidence interval [CI] -0.47 to -0.21; p < .001) and stress (SMD = -0.36; 95% CI: -0.52 to -0.20; p < .001) were significantly reduced after CBT, relative to comparator groups, while anxiety was not (SMD = 0.10; 95% CI: -0.18 to 0.39; p = .47). A subgroup analysis demonstrated that statistically significant reductions in depression and stress were limited to group, but not individual, formats. An additional subgroup analysis revealed that eight CBT sessions or fewer were equally effective as more than eight sessions at significantly reducing depression and stress, relative to comparator groups. Furthermore, analysis with independent samples t-tests demonstrated no statistically significant differences between mean changes in depression (MD = 0.79; 95% CI: -0.45 to 2.03; p = .21) and stress (MD = 0.21; 95% CI: -1.43 to 1.85; p = .80) when directly comparing CBT groups of ≤8 and >8 sessions. Group CBT provides small but significant benefits to caregivers' depression and stress. Therapy cost-effectiveness may be improved by limiting therapy to group formats and eight sessions.

Depression in Main Caregivers of Dementia Patients: Prevalence and Predictors.

Background:The most common neurodegenerative disease is dementia. Family of dementia patients says that their lives have been changed extensively after happening of dementia to their patients. One of the problems of family and caregivers is depression of the caregiver. In this study, we aimed to find the prevalence of depression and factors can affect depression in the dementia caregivers.Materials and Methods:This study was cross-sectional study with convenient sampling method. Our society was 96 main caregivers of dementia patients in the year 2015 in Iran. We had two questionnaires, a demographic and Beck Depression Inventory (BDI). BDI Cronbach's alpha is 0.86 for psychiatric patients and 0.81 for nonpsychiatric persons, and Beck's scores are between 0 and 64. We used SPSS version 22 for statistical analysis.Results:According to Beck depression test, 69.8% (n = 67 out of 96) of all caregivers had scores in the range of depression. In bivariate analysis, we found higher dementia severity and lower support of other family members from the caregiver can predict higher depression in the caregiver. As well, in regression analysis using GLM model, we found higher age and lower educational level of the caregiver can predict higher depression in the caregiver. Moreover, regression analysis approved findings about severity and support of other family members in bivariate analysis.Conclusion:High-level depression is found in caregivers of dementia patients. It needs special attention from healthcare managers, clinicians and all of health-care personnel who deals with dementia patients and their caregivers.

Critical Comment on Depression in Main Caregivers of Dementia Patients: Prevalence and Predictors.

Critical Comment on Depression in Main Caregivers of Dementia Patients: Prevalence and Predictors.

What Behavioral and Psychological Symptoms of Dementia Affect Caregiver Burnout?

ABSTRACTObjectives: Patients’ irritability and aggression have been linked to caregiver depression, but the behaviors that most burden caregivers are not yet definitively identified. This study examines the connection between behavioral and psychological symptoms of dementia (BPSD) and the burnout of caregivers caring for home-dwelling elders with dementia symptoms in Japan.Methods: 80 Japanese rural and urban family caregivers completed detailed questionnaires about their experiences in caring for demented family members. We statistically analyzed the results for correlations between types of dementia, Pines Burnout, and Caregiver Distress.Results: BPSD symptom severity significantly correlated with caregiver distress. The dementia symptoms most strongly correlated with caregiver burnout were: aggression, irritability, abnormal motor behavior, and hallucinations.Conclusions: Among the commonest symptoms, apathy, anxiety, and depression did not seriously aggravate caregiver burnout. Caregivers displayed higher burnout facing agitation/aggression, irritability, aberrant motor behavior, and hallucinations. Caregivers’ reported distress was surprisingly dissimilar to their burnout scores; patients’ delusions and anxiety led to higher distress reporting but not to burnout.Clinical Implications: Advance diagnosis of BPSD symptoms should be helpful to support nurses and caregivers of dementia patients. Particular support should be considered for caregivers and nurses of patients expressing aggression, irritability, abnormal motor behavior, and hallucination.

Attachment style and filial obligation in the burden of caregivers of dementia patients

Insecure attachment styles have been known to predict greater burden in caregivers of dementia patients. However, it has not been tested how filial obligation, which refers to one’s sense of duty on helping elderly parents and is especially pronounced in Asian cultures, is involved in that relationship. We sought to identify whether the association between attachment style and caregiver burden differs according to the degree of filial obligation in caregivers of dementia patients. To assess filial obligation in Korean participants, a Korean filial obligation measure was developed. Ninety-eight Korean female caregivers of dementia patients reported their attachment style, filial obligation, burden, and patient behavioral symptoms. Patients’ cognitive abilities, daily activity levels, and global dementia severities were obtained from hospital records. When adjusting for caregiver and patient characteristics, greater attachment anxiety predicted higher burden, corroborating literature findings. However, the association of attachment avoidance with burden was contingent on filial obligation: When obligation was high, greater avoidance associated with lower burden, which contrasts with previous negative implications of attachment insecurity. This implies a buffering role of attachment avoidance among those highly obligated. In addition, obligation positively predicted burden among those low in avoidance. This study is the first one to investigate and find conditional associations between attachment style, filial obligation, and caregiver burden. Given that filial obligation tends to be higher in caregivers of Eastern countries, this study provides quantitative evidence that the caregiving process may be different for them.

Prevalence of Depression among Caregivers of Dementia Patients

Background: Depression is a common problem af fecting caregivers of dementia pat ients . Factors such asc ar egi v e rs ’ ag e, g en de r, ed ucational level , mari tal status and financial status may play a role in care givingrelated depressive disorder.Aim: to detect the prevalence of depression among caregivers .Methods: The study included 96 caregivers for demented elderly patients. Depression among caregivers was assessed using PHQ-9 scaleResults: T he c a r egi v e rs ’ m ea n ag e was (4 2. 94 ) ± 1 3.1 7 y e a rs . (69.7%) of the care givers were women. More than hal f of them (52%) were mar ried. (38.5%) of caregivers had moderate to severe depression, (43.7%) had mi ld to moderate depression and (17.7%) were wi th minimal depressive symptoms .Conclusions: Caregivers of patients wi th dementia are prone to depression and physical ai lments. Caregiverfactors predicting l iabi l i ty to caregiver burden are c a re gi v e r ’ s fi n anc i al s t at us , c a re gi v e r’ s ed uc a ti o n l ev el am on gother socio-demographic variables.

Forgiveness as an Intervention among Caregivers of Dementia Patients: Case Report

Forgiveness as an Intervention among Caregivers of Dementia Patients: Case Report

Older New Zealanders in caregiving roles: Psychological functioning of caregivers of people living with dementia.

Research suggests that caregiving can have both positive and negative effects on psychological functioning. It is, however, less understood how these positive and negative effects interact within individuals. The present study aimed to identify different patterns of psychological functioning and their correlates among caregivers of dementia patients. The sample included 336 older caregivers. Latent profile analysis revealed three distinct profiles. The optimally functioning profile was characterized by high levels of positive outcomes and low levels of depression. Those with a suboptimally functioning profile reported low levels of positive outcomes and increased depression symptoms. The poorly functioning profile displayed extremely high levels of depression symptoms and extremely low levels of positive outcomes. Differentiation among groups was driven by differences in social support and to a lesser extent by socio-demographic factors and caregiving experience. Results suggest that caregiving is not necessarily a burdensome role and highlight the role of social relationships.

Evaluation of DementiaNet, a network-based primary care innovation for community-dwelling patients with dementia: protocol for a longitudinal mixed methods multiple case study

IntroductionPrimary healthcare professionals will increasingly be required to manage and optimise their treatment for patients with dementia. With DementiaNet, we aim to reduce the burden of dementia on healthcare services...

A Preliminary Qualitative Analysis on the Feasibility of Using Gaming Technology in Caregiver Assessment

ABSTRACTThis exploratory qualitative study examined the feasibility of utilizing gaming technology that will ultimately assess task performance and stress among caregivers of dementia patients. The long-term goal is to use this unobtrusive application (app) to detect caregiver burnout for the purposes of early intervention. This preliminary study examined participant interface with a specific gaming technology called CAST (Caregiver Assessment Using Serious Gaming Technology). Ten dementia caregivers participated. Participants attended a demonstration and then interacted with a preliminary version of the CAST tablet application. Social work researchers interviewed participants using open-ended questions to gauge interest, technology skill level, and comfort with the app. Participants expressed interest and identified potential ways to further develop the system in order to increase ease of use, decrease time commitment, and improve suitability for daily use. The provided feedback will be used to refine the user interface of the application, which will then be used to monitor caregivers’ stress in future development.

EFFICACY OF GROUP PSYCHOTHERAPY FOR CAREGIVERS OF DEMENTIA PATIENTS

In the field of dementia, growing evidence of non-pharmacologic therapy for the patients has been emerged; however, studies focusing on supporting their caregiver's mental stress are limited. Group psychotherapy has originally developed among psychology/psychiatry field, aiming the patients’ mutual interaction and communication, together with clinical psychologists and practitioners. It is unclear whether the applicability and the efficacy of this type of psychotherapy for caregivers of dementia patients. Therefore, we had started up the group psychotherapy team in 2007 including psychiatrist, nurse and clinical psychologist, and have continued to provide this therapy for a decade. The scheme of our group psychotherapy consists of mixture of counseling, psychoeducation and family association. The purpose of this study was to examine the efficacy of group psychotherapy. We recruited the caregivers of dementia patients who agreed with the informed consent with respect to the concept of this therapy and the purpose of this study. All individuals had been aware that they had some stresses in daily care of the patients at the enrollment. Our group psychotherapy was registration-based, biweekly 60 minutes five sessions. To assess the efficacy, the endpoint was determined as the score change between the initial and the last assessment of the series of psychological tests using Japanese version of Profile of Mood States-Brief (POMS), Self-rating Depression Scale (SDS) and Zarit Caregiver Burden Interview (ZBI). 142 caregivers (126 female (89%), mean age 60.7±11.5 years) were included in this study. In POMS, the tension-anxiety and fatigue were tend to be higher. For POMS and SDS, score change from the initial and the last assessment were not significantly different. By contrast, ZBI score decreased significantly (p <0.01) after five sessions. Regarding gender difference, there was no male dominancy among POMS, SDS and ZBI scores, although the sample size was small. The present study indicates that our present group psychotherapy could specifically ease the care burden of dementia caregivers. To compensate the potential problem such as hesitation for attending seen among males, the scheme should be updated continuously.

THE MEDIATING ROLE OF SLEEP QUALITY ON WELL-BEING OF WORKING FAMILY CAREGIVERS

It has been recognized that many caregivers of dementia patients have sleep problems, and that these sleep problems are often related to the nighttime behaviors of the care recipients. Recent studies have found that approximately two-thirds of caregivers suffer from sleep disturbances, and that poor quality of sleep of caregiver is linked not only to physical and psychological burdens but also to an increased risk of depression. This study aimed to investigate whether the well-being of caregivers is mediated by sleep quality and its relationship to behavioral and psychological symptoms in elderly relatives by using a mediational model. We studied 105 working family caregivers (49 men and 56 women, aged 21–64 years) in a cross-sectional design. We assessed well-being based on scores from the K10 scale, subjective self-rated health and satisfaction with daily life. Well-being of caregivers was impacted by the level of behavioral and psychological symptoms that elderly relatives were experiencing. Quality of sleep also affected well-being in working family caregivers, and that has role which controlling affect from behavioral and psychological symptoms in elderly relatives. In conclusion, maintaining quality of sleep in working family caregivers is important for reducing caregiver frustration and improving the balance between work and family life. If caregivers can maintain a high quality of sleep, caregiver burdens and the psychological distress are reduced; therefore, high quality of sleep not only promotes positive control of life and health but also improves overall well-being in caregivers.

A study on clinical nursing research trends and hotspots based on bibliometric analysis

Abstract Objective This study was conducted to understand the trends and research hotspots of clinical nursing in China and abroad, thereby to provide guidance for nursing practice and studies. Methods We retrieved clinical nursing literature (excluding literature related to psychological nursing and traditional Chinese medicine nursing) cited in Wanfang Data ( www.wanfangdata.com.cn ) and PubMed between 2007 and 2015 and subsequently performed bibliometric analyses on article volume, journal, clustering of high-frequency keywords, and co-occurrence of keywords. Results A total of 10374 publications, excluding those related to psychological nursing, were retrieved via a PubMed search. The literature displayed a rising trend in terms of annual publication volume. The journal distribution of clinical nursing publications overall was consistent with Bradford's Law. The main contents of clinical nursing literature between 2007 and 2009 included: (1) studies on effects of the midwife and midwifery methods for natural childbirth; (2) studies on emergency nursing care; (3) studies on dementia care; (4) studies on bandage dressing in trauma nursing; and (5) studies on quality of life in cancer patients nursing. The main contents of clinical nursing literature between 2010 and 2012 included: (1) studies on obstetric nurse–patient relationships; (2) studies on patients' medical team in stroke nursing; (3) studies on cancer nursing methods; (4) studies on nursing patients with trauma related to urinary incontinence; and (5) studies on the quality of life of caregivers of dementia patients. The main contents of clinical nursing literature between 2013 and 2015 included (1) studies on skin care and bandaging in trauma nursing; (2) studies on evidence-based nursing in AIDS care; (3) studies on nurses' role in obstetric nurse–patient relationships; studies on cancer nursing methods; (4) studies on nursing for Alzheimer's disease and dementia; and (5) studies on caregivers and nursing of stroke patients. A Wanfang Data search retrieved a total of 85570 publications, whose volume also exhibited an annual rising trend, in particular with regard to those in core journals. However, percentage of total publication volume, mean cited frequency per article, and total ranking of clinical nursing publications overall displayed a decreasing trend. The main contents of clinical nursing literature between 2007 and 2009 included: (1) diabetes nursing; (2) nursing for cancer; (3) nursing for senility-related diseases; (4) nursing in the event of complications; (5) nursing for hypertension; (6) studies on quality of life after nursing interventions; (7) chemotherapy nursing; (8) studies on compliance after nursing interventions; (9) constipation nursing; and (10) nursing for stroke patients. The main contents of clinical nursing literature between 2010 and 2012 included: (1) diabetes nursing; (2) nursing for cancer; (3) nursing for senility-related diseases; (4) studies on quality of life after nursing interventions; (5) nursing in the event of complications; (6) nursing for hypertension; (7) prevention nursing; (8) perioperative nursing; (9) pain nursing; and (10) studies on compliance after nursing interventions. The main contents of clinical nursing literature between 2013 and 2015 included: (1) diabetes nursing; (2) nursing in the event of complications; (3) cancer nursing; (4) studies on quality of life after nursing interventions; (5) nursing for stroke patients; (6) nursing for the elderly; (7) studies on compliance after nursing interventions; (8) nursing for hypertension; (9) constipation nursing; and (10) prevention nursing. Conclusions Clinical nursing research in China is in a rapid development stage as defined by Price's law whereby there is a rapid growth in publication volume. By comparison, clinical nursing research in developed countries is in the stable development stage or maturation phase, which is characterized by a flat curve of publication volume and stable development rate. There is a gap of 25–30 years between China and these countries in terms of the growth phases of clinical nursing literature.