Caregivers Of Inpatients Research Articles

How short is too short? A randomised controlled trial evaluating short-term existential behavioural therapy for informal caregivers of palliative patients

Background: Informal caregivers of palliative patients show higher levels of depression and distress compared with the general population. Fegg’s (2013) existential behavioural therapy was shortened to two individual 1-h sessions (short-term existential behavioural therapy). Aim: Testing the effectiveness of sEBT on psychological symptoms of informal caregivers in comparison with active control. Design: Randomised controlled trial. Setting/participants: Informal caregivers of palliative in-patients. Methods: The primary outcome was depression; secondary outcomes were anxiety, subjective distress and minor mental disorders, positive and negative affect, satisfaction with life, quality of life and direct health care costs. General linear mixed models allow several measurements per participant and change over time. Reasons for declining the intervention were investigated by Rosenstock’s Health Belief Model. Results: Overall inclusion rate was 41.0%. Data of 157 caregivers were available (63.1% females; mean age: 54.6 years, standard deviation (SD): 14.1); 127 participants were included in the main analysis. Participation in sEBT or active control was not significantly associated with post-treatment depression. Outcomes showed prevailingly significant association with time of investigation. Self-efficacy, scepticism of benefit of the intervention, belief of better coping alone and support by family and friends were significant factors in declining participation in the randomised controlled trial. Conclusion: Inclusion rate was tripled compared with a previously evaluated longer EBT group intervention. By shortening the intervention, inclusion rate was traded for effectiveness and the intervention could not impact caregivers’ psychological state. Early integration of sEBT and combination of individual and group setting and further study of the optimal length for caregiver interventions are suggested.

Optimism and the Psychological Recovery Process Among Informal Caregivers of Inpatients Suffering From Depressive Disorder: A Descriptive Exploratory Study.

Background: Informal caregivers of people suffering from depressive disorders go through a psychological recovery process. This process is dynamic, deep, catalyzed by hope and optimism and characterized by stages from which specific needs ensue. This study aimed to describe the stages of the psychological recovery process and the level of optimism among informal caregivers of psychiatric inpatients suffering from depressive disorders in order to provide adapted nursing support and psychoeducation and facilitate a patient's own recovery.Methods: A descriptive exploratory study was conducted using a convenience sample of 29 informal caregivers. Participants filled out a sociodemographic questionnaire, a specially adapted Stages of Recovery Instrument (STORI) and the Life Orientation Test–Revised (LOT–R).Results: A mean optimism score of 16.41 showed that informal caregivers are close to the level of the general European population. The sample included all the stages of the recovery process, with 34.5% of participants being in the growth stage. Informal caregivers' stages in the recovery process were negatively associated with the patient's length of illness (Rho = -.683, p = .000) and positively associated with the caregivers' level of optimism (Rho = .564, p = .001).Conclusion: During the inpatient treatment of a close relative suffering from a depressive disorder, informal caregivers go through an individual psychological recovery process involving several stages. In addition to caring for inpatients, nurses are encouraged to meet and support caregivers as soon as possible in their individual recovery process. Furthermore, the development of a suitably adapted clinical tool would facilitate the assessment of the informal caregiver's stage in the recovery process within care units. A multidisciplinary approach is needed in this domain.

Interventions supporting caregiver readiness when caring for patients with dementia following discharge home: A mixed-methods systematic review.

To explore programs and information provided to caregivers of inpatients with dementia to assist with readiness to provide care following discharge. A mixed-methods systematic review with meta-analysis was conducted. Search terms included dementia, inpatient, caregiver, anxiety, discharge and counselling. The search yielded 1938 studies (six databases), 13 met the inclusion criteria. Meta-analysis showed no statistically significant changes in anxiety, depression, burden or quality of life 3months postintervention. Three emergent qualitative themes for staff consideration are as follows: understanding personal characteristics of both patient and caregiver; presenting an inclusive organisational culture; and providing appropriate information at all stages of admission. A Model of Caregiver Readiness was created from the qualitative results. The programs did not significantly decrease the outcomes measured. However, caregivers identified that inclusion at all stages during hospital admission was a vital factor to reduce stress and increase caregiver readiness.

Willingness of in-patients to uptake the vital contributor social health insurance program in a teaching hospital, Southwest Nigeria

Background: The introduction of the Vital Contributor Social Health Insurance (SHI) Program in Nigeria was to scale up access to health insurance and achieve universal health coverage. However, many Nigerian in-patients still pay out-of-pocket for health services. This study aimed to determine Nigerian in-patients' willingness to pay for the Vital Contributor SHI Program. Methodology: A cross-sectional analytical study conducted among 133 adult in-patients and care-givers of pediatric in-patients of a tertiary health facility in southwestern Nigeria, not under a health insurance cover, and recruited through a simple random sampling technique. Data were collected using an interviewer-administered questionnaire. Willingness to Pay was assessed using the double contingent valuation by the Bidding method. Descriptive and inferential statistical analysis was performed using the IBM SPSS version 20 with inference made at P > 0.05. Results: Findings showed a low awareness (42.1%) of the National Health Insurance Scheme (NHIS), and much lower awareness of the Vital Contributor Insurance Scheme, (27.1%). A high proportion of the respondents (67.7%) were willing to participate in the scheme, whereas 67.3% of those not willing to participate gave insufficient funds as the reason. The median maximum amount of premium respondents were willing to pay annually was ₦15,000 ($38) and ₦5000 ($12.8) interquartile range. Respondents in the working population (P = 0.032), with some form of education (P = 0.002), having difficulty with paying their medical bills (P = 0.044), who were aware of the Vital Contributor Scheme (P = 0.001) and were knowledgeable about the NHIS benefits (P = 0.026) were significantly more willing to uptake the Vital Contributor SHI Scheme. Conclusion: Although awareness of the Vital Contributor SHI Scheme is low, the proportion of respondents willing to partake in it is satisfying. Increased targeted awareness campaigns should improve uptake. Health management organizations should take the lead in the awareness creation process.

What Contributes to Satisfaction with Care for Family Caregivers of Terminal Cancer Patients Admitted to General Wards? A Qualitative Study

Satisfaction with care is an important indicator for family caregivers of patients with terminal cancer and is linked to the quality of life. Despite this, few studies have examined the aspects of satisfaction with care of family caregivers of inpatients with cancer in general wards. This qualitative study aimed to elucidate the elements of satisfaction with the care that inpatients with terminal cancer in general wards and their family caregivers receive from medical staff, as perceived by the family caregivers. Semi-structured interviews were conducted with 10 family caregivers of inpatients with terminal cancer. Participants were asked about the care received until then from medical staff, the features of satisfactory care, and the aspects of care they felt were unsatisfactory or could become satisfactory with improvement. The data were analyzed with the content analysis method and the six categories were extracted. For family caregivers of inpatients with terminal cancer in general wards, along with the care identified as important in palliative care, the methods of alleviating symptoms and explaining the patient’s condition were also important. The results highlight the importance of determining a patient-oriented approach and explanations together with each patient and family caregiver, based on an understanding of the long treatment process.

Loneliness and Burden Perceived by Family Caregivers of Patients With Alzheimer Disease.

The present study aimed at investigating loneliness and burden experienced by family members caring for relatives diagnosed with Alzheimer disease. Participants were 40 caregivers of inpatients with Alzheimer disease. Correlation and multiple regression analyses were conducted to investigate whether caregivers' loneliness (uni- and multidimensional) and burden are associated with and predicted by (1) specific caregiver characteristics and/or (2) patients' dementia severity and neuropsychiatric symptoms. Loneliness was significantly correlated with caregivers' sex, age, and living circumstances, while burden was significantly correlated with caregivers' education solely. Regression analyses revealed that caregivers' sex and living circumstances contributed significantly to variance explanation of loneliness (but not burden), while the additional consideration of patient variables did not improve model fit. Loneliness reported by caregivers of relatives diagnosed with dementia is significantly modulated by caregiver (but not patient) characteristics. Notably, both uni- and multidimensional loneliness scales seem to be sensitive diagnostic tools.

The relationships among insecure attachment, social support and psychological experiences in family caregivers of cancer inpatients.

To explore the psychological experiences of the family caregivers of inpatients with gastric cancer or colorectal cancer, and to identify the relationships among insecure attachment, social support, and psychological experiences. The study design is a cross-sectional quantitative study collecting data through the use of four questionnaires, including the Hospital Anxiety & Depression Scale, the Self-esteem subscale of the Caregiver Reaction Assessment Scale,the Experience in Close Relationship Scaleand the Social Support Rating Scale. Hierarchical regression analysis and path analysis were used to analyze the collected data. Data from 207 participants was used. Family caregivers had experienced both depression and high self-esteem. Social support has significant direct effects on both depression and self-esteem. Attachment anxiety had direct effects on depression and social support, attachment avoidance had direct effects on self-esteem and social support. Social support has mediated the relationship between adult attachment and psychological experiences. Caregivers had experienced both negative and positive psychological outcomes. There were differences in the effects of insecure attachment on psychological experiences. Social support plays an important role in the relationships among insecure attachment, depression, and self-esteem. Insecure attachment styles and social support should be considered in tailored interventions for family caregivers to reduce their depression and enhance their self-esteem.

Factors Influencing Family Burden in Pediatric Hematology/Oncology Encounters.

Caring for a child with cancer or hematologic disease places unique stress on a family unit. Families' subjective experience of this care-related burden mediates the relationship between cost and health-related outcomes. While financial costs are well described for families of pediatric hematology/oncology patients, it is unclear how cost and other factors each contribute to families' overall experience of care-related burden. This study identifies and groups the challenges that families report and describes their association with overall reported burden. This mixed-methods analysis of a cross-sectional single-center study was conducted via structured, self-administered questionnaire provided to inpatient and outpatient caregivers of pediatric hematology/oncology patients. Respondents rated their perception of burden associated with that day's medical encounter on a 5-point Likert scale. The questionnaire included an open-ended prompt for caregivers about areas they deemed most burdensome. Primary themes were extracted and categorized. A total of 278 outpatient and 42 inpatient caregivers participated. Six thematic categories emerged: logistics, life disruption, care delivery system, parking, financial burden, and emotional burden. Outpatient caregivers reported more burden than inpatient caregivers for the first three categories, while inpatient caregivers reported more burden for the last three. Salient subthemes associated with higher and lower overall burden were identified in each theme category. These data establish theme categories for future study of caregiver-perceived burden in pediatric hematologic/oncologic encounters, demonstrate that certain components of cost contribute disproportionately to caregivers' overall sense of care-related burden, and identify areas within each of the 6 burden categories that can be best targeted to alleviate caregiver burden.

Costs incurred by caregivers of under-five inpatients with community-acquired pneumonia at a university hospital in south-western Ethiopia.

BackgroundPneumonia is one of the commonest diseases among children in Ethiopia resulting in deaths and hospitalisations. The objective of the current study was to determine the cost incurred by caregivers of under-five children with community-acquired pneumonia admitted to the paediatric ward of Jimma University Specialized Hospital, south-western Ethiopia.MethodsAn institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23.ResultsAmong the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers.ConclusionThis study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children.

Pediatric diabetes inpatient care: can medical staff knowledge be improved?

Background The purpose of this study was to assess the benefit of a short workshop addressing knowledge and confidence of inpatient caregivers (physicians and nurses) treating pediatric type 1 diabetes mellitus (T1DM) patients. Methods Questionnaires to determine familiarity with T1DM management and confidence in care were distributed at three university-affiliated medical centers. A 5-h practical-skills workshop was conducted at one center. Same questionnaires were filled out immediately after the workshop and 3 months later. Evaluation of knowledge was based on 16 multiple-choice questions, and confidence based on 10 categorical questions. Results Nurses and physicians (total 135, 106 women, 85 nurses) completed the questionnaires. The median knowledge score was 53.33 (40-66) and 46.7 (26.7-66.7) for nurses and physicians, respectively (p = 0.76). The confidence scores were 1.44 (1.1-1.9) and 1.56 (1.2-1.8), respectively (p = 0.7). More experience among nurses (>10 years) was associated with higher confidence scores (p = 0.04). Twenty-one physicians and 52 nurses, 66 women, attended the workshop. The median knowledge grade improved from 60 (47-67) to 81 (69-81), p < 0.001, immediately after, and to 69 (63-81), p < 0.001, 3 months post-workshop. The median confidence score improved from 1.8 (1.6-2) to 2.4 (2.1-2.6), p < 0.001, and to 2.2 (2-2.6), p < 0.001, respectively. There was no association with profession or seniority. Conclusions Knowledge and confidence in care of medical staff treating inpatient T1DM pediatric patients are lacking. Both improved significantly after the workshop, independent of seniority or profession.

Improving Coping Styles in Family Caregivers of Psychiatric Inpatients Using Planned Behavior Problem-Solving Training.

The consequences and high costs of psychiatric disorders impact family caregivers greatly. Health services should identify and provide accessible support programs to facilitate effective caregiver coping. The aim of this study was to determine the effectiveness of a theory-of-planned-behavior-based problem-solving training program on the coping styles of family caregivers of psychiatric inpatients. In this two-group, randomized control trial, 72 family caregivers were randomly assigned to either a control group receiving standard care or an intervention group receiving a training program (eight sessions over 4 weeks). Demographic information was recorded at baseline, and the Coping Inventory for Stressful Situations was administered to both groups at baseline, immediately postintervention, and 1-month follow-up. Immediately after the intervention, the intervention group earned significantly higher task-oriented coping style scores (mean difference = 5.03, p = .015) than the control group, but no significant difference was detected between the two groups for either emotion- or avoidance-oriented coping style scores. At 1-month follow-up, the intervention group earned significantly higher scores than the control group for task-oriented (mean difference = 8.56, p < .001) and emotion-oriented (mean difference = 7.14, p = .002) coping styles. No improvement in avoidance-oriented coping style at the postintervention or follow-up time points was detected. Implementation by nurses and other health professionals of problem-solving training programs that are based on the theory of planned behavior is recommended to strengthen the use of task- and emotion-oriented approaches that help family caregivers of psychiatric patients better cope with stress.

Comparison of impact of family stigma on quality of life among caregivers of male inpatients with alcohol and opioid use disorder.

Background:Caregivers of patients with alcohol and opioid use disorder (OUD) have low quality of life (QoL) and suffer from family stigma. However, impact of family stigma on QoL has not been studied in this population.Materials and Methods:One hundred primary caregivers of male inpatients with severe alcohol use disorder (AUD) (n = 47) and OUD (n = 53) as per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition were enrolled into the cross-sectional, descriptive study.Participants were assessed using sociodemographic and clinical proforma, World Health Organization QoL-BREF Hindi, and Hindi family stigma scale. Kolmogorov–Smirnov tests and Pearson’s correlation were used for statistical analysis.Results:Majority of caregivers were females (64%), homemakers (48%), and married (80%). More than 50% of caregivers resided in rural areas and nuclear families. 46%, 30%, and 24% of caregivers were parents, wives, and siblings and children. Males, caregivers between 31 and 45 years of age, and married caregivers had significantly higher QoL. Parents had significantly lower QoL. Caregivers of patients with AUD had significantly lower overall QoL than that of OUD. Wives faced higher discrimination and overall stigma. Overall QoL, satisfaction with physical health, and environment were significantly negatively correlated with discrimination. Total stigma was negatively correlated with satisfaction with environment.Conclusion:Stigma and discrimination have negative impact on QoL of caregivers. Stigma reduction and QoL enhancement should be integral part of psychosocial interventions for caregivers of patients with AUD and OUD.

Usefulness of 3'- 5' IS6110-RFLP genotyping and spoligotyping of Mycobacterium tuberculosis isolated in a tertiary hospital: a retrospective study detecting unsuspected epidemiological events.

ABSTRACTA drug resistance survey involving Mycobacterium tuberculosis isolated from patients of a tertiary Hospital in the Rio de Janeiro city (RJ), Brazil, between the years 1996 and 1998 revealed a high frequency of isoniazid (HR) resistance. These isolates were revisited and genotyped. Patients came from different RJ neighborhoods and municipalities, and 70% were outpatients. Applying the 3’ and 5’ IS 6110 -RFLP and the Spoligotype genotyping methods, the clonal structure of this population was investigated obtaining a snapshot of past epidemiological events. The 3’ clusters were subsequently 5’ IS 6110 -RFLP typed. Spoligotyping was analyzed in the SITVIT2 database. Epidemiological relationships were investigated. The major lineage was T (54.4%), and SIT 53/T1 and SIT 535/T1 were the most frequent. The T1 sublineage comprises 12.8% of resistant strains and SIT 535 were assigned for 31.8% of them. Orphan patterns corresponded to 12% and 73.3% and belonged to the T lineage. One pattern was unlisted in the SITVIT2. The 5’ IS 6110 -RFLP did not confirm 3/12 of the 3’ IS 6110 -RFLP clusters. A combination of all methods decreased the number of clusters to three. Nosocomial transmission was associated with one cluster involving a hospital cupbearer. This event was suspected in a multidrug resistant-TB inpatient caregiver who harbored a mixed infection. The 3’ IS 6110 clusters were associated with HR (p=0.046). These genotypic retrospective data may reflect a fraction of more extensive recent transmission in different communities that may be corroborated by the concentration of HR patients, and may serve as a database for further evolutionary and characterization evaluation of circulating strains and together with epidemiological data favors a more effective transmission control.

Caregiver Preparedness Training Within Inpatient Brain Injury Rehabilitation: A Scoping Review

To examine caregiver training used within brain injury inpatient facilities, report descriptions of caregiver trainings and mastery outcomes, and report hospital-driven cost outcomes to determine hospital benefit. The review informs recent policy that advocates for providing inpatient caregiver training for families of clients with acquired brain injuries. Providing this evidence will also inform practice to ensure that caregiver needs are met, best practice is established, and hospital readmission costs are reduced.

Anxiety and depression among caregivers of inpatients suffering from chronic debilitating and terminal illnesses

Background: Depression and anxiety are the priority conditions covered by WHO’s Mental Health Gap Action Programme. Depression is a common illness worldwide, despite effective treatments available, fewer than half of those affected receive such treatments. Caregivers of the patients, attributed to bear higher burden of personal, financial, family, and social problems are expected to be predisposed to psychological illness. Thus this study was undertaken with following objectives; i) to estimate prevalence of anxiety and depression and ii) to find associated factors for anxiety and depression among in-patient care givers of a tertiary care hospital.Methods: An observational study was undertaken in the cardio, neuro, medical and cancer in-patient setting, in a tertiary care hospital, of Kalaburagi district. Study was undertaken for 2 months from Dec-2017 to Jan-2018. Care-givers of all, receiving in-patient care were included in the study. The anxiety and depression levels were assessed using GAD-7 &amp; PHQ-9 questionnaires respectively.Results: All in-patient care-givers had some degree of anxiety of which majority of them had severe level of anxiety (50%). Likewise, 96% of the subjects had some degree of depression, of which 40% of them had moderately severe level of depression. Severe levels of anxiety and depression were found to be high among 30-40 years age group.Conclusions: It is crucial to screen the care givers, especially females, for presence of anxiety and depression. This approach will help timely identification and proper management of these individuals.

A comparative study of caregiver burden and self-efficacy in chronic psychiatric illness and chronic medical illness: A pilot study

Background: A caregiver is an individual who provides assistance and assumes the responsibility for the physical and emotional needs of another individual who is incapable of self-care. Caregiver burden is a universal phenomenon and more than half of the caregivers experience burden in their role as caregivers. There is a paucity of studies to understand the burden and coping strategies of caregivers in chronic psychiatric illness and chronic medical illnesses, especially in the Indian scenario. Aims and Objectives: (i) To compare the caregiver burden in chronic psychiatric illness and chronic medical illness (ii) To compare the caregiver efficacy in chronic psychiatric illness and chronic medical illness. Materials and Methods: The study sample included caregivers of inpatients admitted in a tertiary care hospital in South India. A total of 120 caregivers were included in the study with 60 caregivers from psychiatric ward and medicine ward, respectively. The caregivers were then assessed using the Caregiver Burden Scale and the Revised Caregiver Self-efficacy Scale Results and Conclusion: We found that majority of the caregivers were first-degree relatives and women constituted a major part of the caregiver group. Caregiver burden was significantly higher in psychiatric illnesses compared to medical illnesses. Caregiver efficacy was similar in both study groups. Interventions to reduce caregiver burden and to improve caregiver efficacy should be implemented to ensure optimal management of both patient and caregiver.

Diyabetik ayaklı hastaların bakım verenlerinde bakım veren yükü ve yaşam kalitesi

Introduction: The burden of care-giving is defined as the burden sustained by an individual who is giving care to an elderly, chronically ill or incapacitated person; the levels of perception of the burden are known to be affected by various personal and disease-related characteristics. Studies that compare the burden of internal patients’ caregivers with psychiatric patients’ caregivers, reported higher caregiving burden for caregivers of psychiatric patients. In this study, it was aimed to compare the levels of the caregiving burden of those caring for patients with diabetic foot with care-givers of psychotic patients. Caregivers of those with inguinal hernia were designated as the control group to determine the characteristics that are related to the care-giving burden. Methods: The study was comprised of care-givers of 30 hospital in-patients with diabetic foot, 30 in-patients with inguinal hernia, and care givers of 30 patients with a recorded diagnosis of psychotic disorder at Çorum Community Mental Health Centre. The evaluation was made from voluntary completion of the Zarit Burden Interview Form and the Beck Depression, Beck Anxiety, Hospital Anxiety and Depression (HAD) and Short Form-36 (SF-36) scales. Results: The caregivers of the diabetic foot group were found to be mostly non-working females. No difference was found between the burden levels of psychotic and diabetic patient groups but the burden level of caregivers of psychotic patients was determined to be significantly higher than the control group (p&amp;lt;0.001). In comparison with those of the control and psychotic group, the depression and anxiety scales of the diabetic foot group were signficantly high and some points of the quality of life scales were determined to be significantly low. A correlation between the duration of care-giving and the burden was only determined in the diabetic foot group (r=0.421, p=0.020). Conclusion: Care-givers of diabetic foot patients remained more socially isolated. This was probably due to having to live with an elderly person requiring care. For various reasons, care-givers of diabetic foot patients were found to have high levels of anxiety and depression, low quality of life, and burden levels as high as those of the psychotic group. Therefore, in the context of protecting the physical and emotional health of care-givers, careful monitoring and when necessary, supportive treatment would be appropriate.

End-of-life care of elderly patients with dementia: A cross-sectional study of family carer decision-making

BackgroundDementia syndromes pose a major worldwide challenge to public health. In terminal stage of dementia, carers are responsible for decision making in end-of-life treatment and there may be multiple factors that contribute to the choice of a palliative or invasive treatment. AimTo identify possible factors that influence the decision-making of family caregivers on implementing invasive or palliative interventions for people with end stage dementia. DesignA structured interview with family caregivers of elderly patients addressing aspects of the following categories: elderly with dementia, caregiver, medical treatment history. Statistical analysis was performed to test whether there was a significant association between the carer's decision (invasive or palliative treatment) and the collected variables. Settingand participantsThe study was conducted in three hospitals in Brazil. Participants were family caregivers of inpatients with end stage dementia ResultsMost of caregivers chose not to perform invasive procedures. The factors with the greatest association with the decision for invasive care were: elderly with tracheostomy, dementia diagnosis for less than 2 years, caregiver's age less than 50 years, history of hospital admission in the last year, affirmation that interviewee would be surprised with the death of the elderly within 1year and the denial that health care team has already explained about treatment options. ConclusionThere were identified several factors related to the carer, the elderly person and their medical treatment that may influence the choice between palliative and invasive care for the elderly person with dementia.

Effectiveness of Needs-oriented Hospital Discharge Planning for Caregivers of Patients With Schizophrenia

Hospital discharge planning for clients with schizophrenia reduces client rehospitalization rates and improves their medication adherence. The effectiveness of caregiver participation in hospital discharge planning has seldom been explored. The purpose of this study was to examine the effectiveness of caregiver participation in hospital discharge planning for clients with schizophrenia in reducing caregiver burden and improving health status. A quasi-experimental research design was adopted. The research location was in a psychiatric hospital in Northern Taiwan. The target population was caregivers of inpatients with schizophrenia. Nurses served as care coordinators and provided six-step hospital discharge planning services to caregivers. Structured questionnaires were employed to measure caregiver burden and health status. Intervention effect was tested using analysis of covariance in which outcome measure at pretest and selected demographic variables were treated as covariates. A total of 114 caregivers completed pretest and posttest evaluations, with 57 people in each group. A significant difference was found between the experimental and the control group regarding the caregiver burden and health status (P<0.001) The caregiver burden and health status of the experimental group improved more significantly compared with the control group. The caregiver-involved discharge planning process developed in this study effectively reduced the burden placed on caregivers and improved their health status. Mental health nurses can serve as the main care coordinators for assessment, planning, referral and provision of the required services. Caregiver-involved hospital discharge planning should become part of the routine care process.

Inpatient dependency in activities of daily living predicts informal caregiver strain: A cross-sectional study.

To investigate what factors influence caregiver strain in informal caregivers just before inpatients are discharged. Previous research has investigated the risk factors related to the burden on caregivers in different clinical contexts. However, the findings from studies analysing these factors just before inpatients are discharged are uncertain. A cross-sectional study design. The study involved 100 inpatients and 100 informal caregivers from seven different hospital units. Sociodemographic, clinical, functional and cognitive factors of inpatients-caregivers, and caregiver strains were recorded. Descriptive, bivariate correlation and multiple regression analyses were performed. Caregivers of inpatients at risk of ulcers had significantly higher scores of strain. Dependency in activities of daily living scores and cognitive status scores were statistically inversely proportional to caregiver strain. Almost 27% of total variance of caregiver strain was due to dependency in activities of daily living. Caregiver strain was mainly associated with those situations in which the hospitalised patients presented the risk of ulcers, dependency and cognitive disorders, with dependency in activities of daily living being the factor that most influenced informal caregiver strain. Dependency in activities of daily living, among other risk factors, should be evaluated at an early stage, monitored and controlled by hospital nursing staff. These strategies could protect and promote the well-being and quality of life of informal caregivers during patient hospitalisation and after discharge.