Spousal Caregivers Research Articles

Effects of a couple-based self-efficacy intervention on health outcomes among colorectal cancer patients and spousal caregivers: A randomized controlled trial

PurposeThis study aimed to assess the feasibility and acceptability of a couple-based SE intervention, and to examine the effects of the intervention on health outcomes for CRC couples. MethodsAn assessor-blinded, two-armed, randomized controlled design was used. The study randomly assigned 144 patients hospitalized for CRC to receive either the SE intervention or the usual care. SE was the primary outcome. The secondary outcomes included quality of life and mental health (positive emotions and negative emotions). Repeated measures analysis of variance was used to examine the data. ResultsThe recruitment and retention rates were 80% and 87.5%, respectively. First, we found that patients scored significantly higher on anxiety (p = 0.001), depression (p = 0.001) and benefit findings (p = 0.009) than did spousal caregivers, whereas spousal caregivers scored significantly higher than patients on the quality of life (p < 0.001 for both physical scores and mental scores) in the SE group. Second, immediately after the intervention, the SE group showed statistically significant improvements were found in SE (p < 0.001 for both couples), quality of life (mental scores) (p = 0.002 for spousal caregivers), negative emotion (anxiety, p < 0.05 for both couples; depression, p = 0.03 for patients), and positive emotion (benefit findings) (p < 0.001 for both couple) when compared to the control group. ConclusionA couple-based SE intervention significantly improved SE, quality of life (MCS scores), and psychological well-being, suggesting a short-term intervention effect.

The congruence and interrelationships of family resilience in couples coping with colorectal cancer: A cross-sectional study from a dyadic perspective.

To assess the congruence and interdependent impacts of family resilience in colorectal cancer couples using the Walsh Family Resilience Model, focusing on coping domains of the shared beliefs system, organizational patterns, and communication/problem-solving. 220 colorectal cancer couples were recruited from two hospitals in China, assessing family resilience, hope, family sense of coherence, spiritual well-being, social support, and couple communication quality. Congruence was assessed using intraclass correlation coefficients and paired t-tests. Pearson correlations, multiple stepwise linear regression, and structural equation modeling examined the effects of coping domains on family resilience. Actor-Partner Independence Model was used to further explore actor and partner effects of these coping domains on family resilience in colorectal cancer couples. Moderate congruence in family resilience was observed, with spousal caregivers reporting higher family resilience. Key coping domains, including shared beliefs system (hope, family sense of coherence, spiritual well-being), organizational patterns (social support), and mutual communication/problem-solving, were significant predictors of family resilience. Importantly, both patients' and spousal caregivers' coping domains exhibited notable actor and partner effects on family resilience of their own family resilience and partners. This study highlights the interdependent influences on family resilience in colorectal cancer couples, supporting family-centered interventions to strengthen positive coping mechanisms.

The relationship between stress, social support, and quality of life among spouses of patients at the end-of-life stage in Thailand: A correlational study.

Non-communicable diseases have become a leading global health challenge, with mortality rates steadily rising. Insufficient patient care can worsen chronic illness, often placing significant caregiving responsibilities on the patient's spouse. In some cases, spouses may need to leave their jobs to provide full-time care, especially during the end-of-life stage. Spousal caregivers often face emotionally distressing circumstances while caring for their loved ones, which can lead to elevated stress levels. However, research indicates that adequate social support can improve caregivers' quality of life, reducing some of the burdens associated with end-of-life care. This study aimed to assess and analyze the relationships between stress, social support, and quality of life experienced by spousal caregivers in Thailand, guided by Lazarus and Folkman's (1984) Stress and Coping Theory. A correlational descriptive study design was used. The study was conducted with 84 spouses of patients in the end-of-life stage at a university hospital between October 2021 and March 2022. Data were collected using a questionnaire covering stress, social support, and quality of life and analyzed using Pearson's Product Moment and Spearman Rank Correlation Coefficients. The majority of spouses were women aged between 31 and 83 years (Mean = 61.24, SD = 10.42). The mean stress level was 6.40 (SD = 1.62), the mean social support was 55.07 (SD = 9.06), and the mean quality of life was 94.69 (SD = 10.04). There was no significant correlation between social support and stress (r = -0.098, p = 0.373). However, stress was negatively correlated with quality of life (r = -0.299, p = 0.006), and social support was positively related to quality of life (r = 0.219, p = 0.045). Spousal caregivers of patients at the end-of-life stage experienced varying levels of stress, social support, and quality of life. While no significant relationship was found between social support and stress, stress negatively impacted quality of life, while higher social support was associated with improved quality of life. Healthcare providers, especially nurses, should assess and address the stress, social support, and overall well-being of spousal caregivers to enhance their quality of life.

A randomized controlled trial of an intervention for unmet supportive care needs addressing colorectal cancer couples.

Supported by the Supportive Care Needs Framework (SCNF), we developed a colorectal cancer (CRC) couple-based unmet supportive care needs (USCNs) intervention program, which has been proven to be feasible. The intention was to assess what the clinical efficacy of this intervention would be in CRC couples. One hundred and sixty-eight CRC couples were randomly assigned to one of two groups: a control group (receiving normal care) or an intervention group (receiving normal care plus a five-week USCNs intervention). Information on USCNs, mutual communication, quality of life, and psychological adjustment was gathered from CRC couples both at baseline and right after the intervention. The collected data were examined using repeated measures analysis of variance (ANOVA). There were 135 CRC couples who completed the five-week intervention and post-intervention outcome measures (retention rate: 80.4%). Combining with the ANOVA results (p<0.001 for both couples) and the intervention effect sizes Cohen's d (d=0.33-0.60 for patients, d=0.22-0.59 for spousal caregivers), the USCNs intervention is effective in improving USCNs, mutual communication, mental health, positive emotions, and negative emotions in CRC couples. The CRC couple-based USCNs intervention effectively reduces USCNs and promotes cancer adjustment among CRC couples. This intervention can assist clinical staff in refining routine care components to enable couples to manage CRC more effectively. In the future, it will be essential to lengthen the follow-up duration to assess the efficacy of the intervention in the long term.

Association Between a Family Caregiver's Relationship to Persons With Dementia and Cardiovascular Disease by Race and Ethnicity: A Secondary Analysis of the Behavioral Risk Factor Surveillance System Data.

Caregiver stress is linked to key mechanisms for developing cardiovascular disease and the burden differs by caregiving relationship (eg, spouse). Furthermore, cardiovascular disease risk in family caregivers (FCGs) has been shown to differ by race and ethnicity. However, little is known about whether the association between caregiving relationship and FCGs' cardiovascular health differs by race and ethnicity. This study examined the association between an FCG's relationship to persons with dementia and risk factors for cardiovascular disease and cardiovascular disease conditions and identified how these associations differed by race and ethnicity in FCGs. This was a secondary analysis of the 2015-2020 Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System data. Logistic regression models were used to examine the associations between predictors (caregiving relationship, race/ethnicity, and their interaction) and outcomes (cardiovascular disease risk and conditions). A sample of 6042 FCGs of persons with dementia were included. When analyzing race/ethnicity groups as a whole, cardiovascular disease risk and conditions differed significantly by caregiving relationship. Notably, spouse caregivers were at higher risk of diabetes, stroke, angina, and myocardial infarction, while showing lower rates of current smoking, heavy drinking, and obesity, compared to adult children. The associations between caregiving relationship and select cardiovascular disease risk factors (depression, previous smoking) differed significantly between racial and ethnic groups. There is a need to develop culturally appropriate cardiovascular preventive health care strategies that reduce cardiovascular disease risks by considering caregiving relationship. Research is especially needed among minoritized racial and ethnic FCG groups.

Determinants of Caregiver Burden Among Spouses of Patients With Kidney Failure: A Qualitative Study.

Spousal caregivers participate extensively in the care of patients with kidney failure. Although previous studies suggested that these caregivers experience a high burden, a comprehensive understanding of the determinants of this burden and strategies to alleviate it are needed. Therefore, this study sought to explore the contributing and alleviating determinants of burden in spousal caregivers of patients with kidney failure. A qualitative interview study with 15 spousal caregivers. Dutch-speaking, adult spousal caregivers were recruited and interviewed by the Dutch Kidney Patients Association for the Kidney Decision Aid. A directed qualitative content analysis using the stress-appraisal model of caregiver burden as a framework to inform a disease-specific model on spousal caregiver burden for kidney failure that characterizes the impact of care provision on all aspects of spousal caregivers' lives, the burden associated with it, and possible mitigating factors. Providing care for patients with kidney failure is complex and burdensome for spousal caregivers and results in many lifestyle changes, which is largely caused by kidney failure-specific tasks and the shifting responsibility for daily life tasks. Spouses identified disease-specific determinants of burden including the impact of kidney disease on afflicted spouses as well as the associated caregiver tasks, e.g., adjusting to dietary restriction and attending dialysis appointments. Dialysis options (e.g., the choice for home or in-center dialysis) were kidney failure-specific moderators of burden. Support of spousal caregivers by healthcare providers plays a key role in preventing overburdening. Potential limited transferability owing to the study of only Dutch-speaking spouses willing to be interviewed and videotaped. This comprehensive overview of the contributing and alleviating determinants of burden experienced by spousal caregivers of patients with kidney failure highlights four principal areas; 1) personal and relational, 2) social environment, 3) healthcare, and 4) work and legislation, in which such burdens occur and may be alleviated.

DYADIC AMBIVALENCE IN ALZHEIMER’S DISEASE: LINKING BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS TO LIFE SATISFACTION

Abstract Caring for a spouse with Alzheimer’s disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers’ ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties’ perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the predictors and well-being outcomes of such ambivalence in this unique context. Participants included 73 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners’ demographic characteristics and their spouses’ behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms. Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers’ ambivalence. Caregivers’ distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses’ life satisfaction but there was also a marginally significant indirect effect via ambivalence. This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.

Over-supplement of vitamin D may cause delirium, abdominal distension, and muscle weakness in the elderly: A case report and literature review

Rationale: Vitamin D deficiency is common among the elderly due to limited sunlight exposure, increasing osteoporosis risk. Over-supplementation poses risks, especially with caregiver involvement. Patient concerns: Rising vitamin D overdose cases underscore the need for better education on safe intake and monitoring practices to prevent toxicity, particularly hypercalcemia from excessive doses. Diagnoses: This case report details the clinical presentation and management of a woman who exhibited progressive lower limb weakness, delirium, and abdominal distension over a 3-day period. Initial assessments ruled out intracranial hemorrhage but revealed significant electrolyte imbalances, including hyponatremia, hypokalemia, hypomagnesemia, and severe hypercalcemia. Upon further inquiry, it was discovered that the patient had consumed an excessive amount of liquid Vitamin D3 over the preceding 3 weeks, surpassing the threshold for vitamin D intoxication. Interventions: Intravenous fluid hydration was initiated to promote calcium excretion. Bisphosphonates and calcitonin were administered to reduce serum calcium levels. Electrolyte imbalances, including hyponatremia, hypokalemia, and hypomagnesemia, were corrected. Continuous monitoring and supportive care were provided in the geriatric ward. Outcomes: After these treatments, the patient’s electrolyte levels stabilized, and her symptoms, such as confusion and muscle weakness, gradually improved, leading to a full recovery. Lessons: This case underscores the importance of recognizing hypercalcemia, particularly in the elderly, where symptoms may manifest nonspecifically. Additionally, it highlights the potential risks associated with medication errors and inadvertent overdoses, particularly in situations involving elderly spousal caregivers.

Psychological Distress among Breast Cancer Survivor and Their Spousal Caregiver

Background: Cancer journey increases the risk for anxiety and depression not only for the breast cancer survivor but also for the spousal caregiver. The purpose of this study was to determine the relationship between psychological distress among breast cancer survivors and their spousal caregivers.Methods: This study used a cross-sectional design where the baseline data on anxiety and depression of breast cancer survivors and their spousal caregivers (dyads) collected for Randomized Controlled Trial were analyzed. Hospital Anxiety and Depression Scale was used to collect data from 64 breast dyads during June to July 2022.Results: Among breast cancer survivors 37.6% had moderate to severe anxiety while 15.6% of spouses had moderate anxiety. Among breast cancer survivors 35.9% had mild, 15.6% had moderate and 4.5% had severe depression level. Among spouses 18.8% had mild and 7.8% had moderate depression level. The anxiety and depression of dyads were positively correlated. There has been significant direct effect of anxiety of survivor on depression of survivors. Moreover, there is significant direct effect of spouse’ anxiety and survivor’s depression on spouse’s depression while survivor’s anxiety has significant indirect effect on spouse’s depression.Conclusions: There has been significant influence of spouse’s anxiety, survivors’ anxiety and depression on the depression level of the spouse. Thus, early dyadic stress management interventions are warranted.Keywords: Anxiety; breast cancer survivor; depression; Nepal; spousal caregiver.

Supporting patients with advanced cancer and their spouses in parenting minor children: results of a randomized controlled trial.

Patients with advanced cancer and their spousal caregivers who parent minor children report unmet parenting concerns and increased psychological distress. Seeking to address these important supportive care needs, this RCT examined the feasibility, acceptability, and initial evidence for the efficacy of a novel psychosocial intervention. Patients with a metastatic solid malignancy and their spouses completed self-reported validated assessments of psychological symptoms and cancer-related parenting outcomes and were then randomized to the parent support intervention or a usual care (UC) group. Both groups were reassessed 6 and 12 weeks later. Dyads randomized to the counselor-led intervention attended the first 2 sessions jointly addressing illness communication and family routines. Spouses individually attended the last 2 sessions focusing on caregiver support and family death preparedness. Fifty patients and their spouses were randomized. All a priori feasibility benchmarks were met. Attendance in the intervention arm was high with 84% of caregivers attending all 4 sessions (mean = 3.48). The program was evaluated favorably by all patients and spouses deeming the intervention as beneficial. Caregivers rated the individual-level sessions as particularly helpful. Multilevel analyses revealed a significant reduction in anxiety symptoms (P = .05) and improvement in parenting efficacy (P = .03) at 6-week follow-up in the intervention group compared with UC. The initial testing of our parent support intervention yielded promising results regarding feasibility and preliminary evidence for efficacy for reduced anxiety symptoms and improved parenting efficacy. This program may meet a frequent and distressing psychosocial need that is typically unaddressed by multidisciplinary oncology teams.

Striking a balance: health behaviour changes in Chinese spouses of people with dementia to manage dementia risk: a qualitative study

BackgroundMultiple studies have shown that spouses of people with dementia (PwD) are two to six times more likely to develop dementia compared to the general population. Encouraging healthy behaviours and addressing modifiable risk factors could potentially prevent or delay up to 40% of dementia cases. However, little is known about how health behaviours change when a spouse assumes the role of primary caregiver. Therefore, the aim of this study was to explore the shared lived experience of spousal caregivers of PwD, focusing on identifying the trajectory and key events of that shape health behaviour changes after their partner’s diagnosis. These findings seek to inform strategies for adopting and sustaining healthy behaviours among spousal caregivers.MethodA qualitative descriptive study was conducted. Using maximum variation and purposive sampling, 20 spouses of PwD who exhibited two or more risk factors were recruited for semistructured interviews. The interviews were transcribed verbatim and analysed using thematic analysis.ResultsWe found that in traditional Chinese culture health behaviour changes for spouses and people with dementia coping with the challenges of dementia occurred in two directions; (a) priming-leaping-coping: becoming a “smart” caregiver and (b) struggling-trudging-silence: the process by which the self is “swallowed.”ConclusionThis study highlights how caregiving experiences influence spouses’ health behaviors and dementia prevention, particularly in the Chinese context. The findings underscore the challenges of balancing caregiving with self-care. Culturally tailored, family-centered interventions are needed to support both caregivers and their long-term well-being.

Communication about incurable illness and remaining life between spouses and patients with incurable illness receiving specialized home care: effects of a family caregiver-targeted web-based psycho-educational intervention

BackgroundWeb-based interventions targeted at family caregivers has become a quickly expanding research field, none the least since a growing number of patients with incurable illness are being cared for at home. Spouses, who are also family caregivers, constitute an especially vulnerable group in need of support when they are cohabitating with the ill patient and research shows that communication regarding the illness is important, yet challenging. This study therefore explored effects of a family caregiver-targeted web-based psycho-educational intervention on communication about incurable illness and remaining life between spouses and patients receiving specialized home care.MethodsThe study had a pre-post-design. An intervention containing videos and texts about family caregiving was developed and made accessible via a website. Thirty-nine spouses (67% women, median age: 61) were recruited from specialised home care services. At baseline, and after 4 weeks of access to the website, spouses completed a questionnaire about communication with the patient regarding incurable illness and remaining life. Data was analyzed using the Wilcoxon signed-rank test.ResultsNo significant changes were found between baseline and follow-up. Most spouses did, however, report having talked with the patient about the illness being incurable (64%) and how the illness affected the patient physically (64%) and psychologically (77%) during the past month already at baseline. Regarding communication about the remaining life and how to manage once the patient had passed away, 46–59% instead reported not having had these conversations with the patient ever.ConclusionsA majority of the spouses had talked about aspects of the illness and its consequences already at baseline, indicating that these matters are important to spousal caregivers of patients with incurable illness. However, a sizeable portion had not ever talked to the patient about how to manage once the patient had passed away, suggesting there are barriers to such conversations that need to be further explored. Future research on web-based psychoeducational interventions targeted at family caregivers need to address barriers and the diverse support needs regarding communication, especially about the remaining life, among spouses of patients with incurable illness.Trial registrationThe study was first registered on clinicaltrials.gov(NCT03676283) on 2018.09.12.

Perceived Social Support Mediates the Relationship Between Benefit Finding and Depressive Symptoms Among Young and Middle-Aged Stroke Survivors and Their Spouse Caregivers

Background Existing literature indicates that benefit finding and social support play protective roles against depressive symptoms. However, there is a lack of understanding regarding the interplay between benefit finding, social support, and depressive symptoms within the dyadic context of stroke survivor-spousal caregiver relationships. Objective The objective of this study is to investigate the relationships among benefit finding, social support, and depressive symptoms in young and middle-aged stroke survivors and their spouse caregivers. In addition, the mediating role of social support in the association between benefit finding and depressive symptoms is explored. Methods A total of 203 pairs of stroke survivor-spouse caregiver were included in the study. Depressive symptoms, social support, and benefit finding were measured using the Patient Health Questionnaire-9, the Perceived Social Support Scale, the Benefit Finding Scale, and the Caregiver Benefit Finding Scale. The Actor-Partner Interdependence Mediation Model was used to assess direct and indirect effect. Results The findings revealed a significant negative association between higher levels of benefit finding and lower depressive symptoms in both stroke survivors (actor effect, −0.126) and spousal caregivers (partner effect, −0.044). Perceived social support emerged as a significant mediator in the relationship between benefit finding and depressive symptoms in spousal caregivers (indirect effect, −0.024). Furthermore, spousal caregivers' perceived social support served as a mediating variable between caregiver benefit finding and depressive symptoms in stroke survivors (indirect effect, −0.023). Conclusion The study underscores the interdependence between stroke survivors and spousal caregivers, highlighting the mutual influence they have on each other. Consequently, targeted interventions addressing both members of the dyad, with a focus on enhancing benefit finding and social support, could prove beneficial in ameliorating depressive symptoms in stroke survivor-spousal caregiver.

Decoding the Mechanism of the Loss of Self in Spouse Caregivers of Alzheimer’s Patients: A Sociocultural and Communication Perspective

Decoding the Mechanism of the Loss of Self in Spouse Caregivers of Alzheimer’s Patients: A Sociocultural and Communication Perspective

Family Sense of Coherence, Dyadic Coping, and Quality of Life in Young and Middle-Aged Patients With Advanced Lung Cancer and Spousal Caregivers: An Actor-Partner Interdependence Mediation Model.

Cancer is now recognized as a dyadic stress that seriously impacts the mental and physical well-being of both patients and their spousal caregivers (SCs). Analyzing from a dyadic perspective whether and how dyadic coping and family sense of coherence (FSOC) affect the quality of life (QOL) of couples is crucial. To investigate the dyadic association between FSOC, dyadic coping, and QOL in young and middle-aged couples facing advanced lung cancer and to evaluate the mediating role of dyadic coping from a dyadic perspective. From October 2023 to April 2024, 202 dyads were recruited from 2 tertiary care hospitals in Tianjin, China. The participants' measurement indicators were evaluated using corresponding questionnaires. The procedure for dyadic analysis was based on the Actor-Partner Interdependence Mediation Model. The actor effect of FSOC on the QOL was mediated by the dyadic coping of patients (β = .100; 95% confidence interval [CI], 0.053-0.155; P = .001) and SCs (β = .124; 95% CI, 0.059-0.193; P = .002). The partner effect suggested that patients' QOL may be indirectly impacted by SCs' FSOC through patients' dyadic coping (β = .078; 95% CI, 0.038-0.127; P = .004). The QOL, dyadic coping, and FSOC of young and middle-aged couples facing advanced lung cancer were dyadically interdependent. To enhance couples' QOL, strategies for intervention must be developed. This study offered a novel viewpoint on the relationship between QOL, dyadic coping, and FSOC and provided a theoretical foundation for the creation of dyadic intervention strategies meant to enhance cancer couples' QOL.

Feasibility and preliminary efficacy of a systematic transaction model-guided dyadic coping nursing intervention for patients with breast cancer and their spousal caregivers: A pilot study

ObjectiveThis study aimed to assess the feasibility, acceptability, and preliminary efficacy of a Systematic Transaction Model (STM)-guided dyadic coping nursing intervention for patients with breast cancer and their spouses. MethodsA single-arm, pre-test/post-test pilot study was conducted at a tertiary hospital in Wuxi, China, recruiting 28 breast cancer patient–caregiver pairs. Each dyad participated in six hybrid intervention sessions. Paired t-tests were used to evaluate pre- and post-intervention changes, and effect sizes were calculated. Feasibility was assessed by recruitment and retention rates, acceptability via the Client Satisfaction Questionnaire-8 (CSQ-8), and preliminary efficacy through measures of body image, dyadic coping, post-traumatic growth, and marital satisfaction. ResultsAll 28 dyads completed the intervention. Patients showed small-to-moderate improvements in body image, post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.4–0.5, P ​≤ ​0.022), with clinically meaningful changes observed in 39%–68% of patients. Spousal caregivers also demonstrated improvements in post-traumatic growth, dyadic coping, and marital satisfaction (d ​= ​0.3–0.6, P ​≤ ​0.033), with 36%–46% showing clinically important differences. ConclusionsThis pilot study supports the feasibility and initial efficacy of an STM-guided dyadic coping intervention, which may benefit breast cancer patients and their spouses as a unit. Further large-scale trials are recommended to validate these findings. Trial registrationChina Clinical Trial Registry (ChiCTR2400083416).

Factors affecting negative and positive emotions among spouses caring for patients with psychotic or bipolar disorder.

Spouses experience conflicting emotions when caring for partners with severe mental illnesses. They can have negative emotions while also regarding caregiving as positive and may develop a better marital relationship through the caregiving process. This study investigated factors affecting the negative and positive emotions of husbands and wives acting as caregivers of their spouses with severe mental illnesses. An online nationwide survey of 166 spouses caring for partners diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder was conducted. Caregivers' negative and positive emotions, personal and role strains in the care burden, sense of coherence, and patients' disabilities in family communication were assessed. We conducted a series of hierarchical multiple regression analyses to evaluate the effects of these factors on the emotions of husbands and wives separately. Among the 166 spouses, 112 (67%) were husbands and 54 (33%) were wives. Husbands were caregivers to 1.4 times as many individuals diagnosed with psychotic disorder as were wives. The negative emotions of husbands were linked to personal strain, whereas those of wives were associated with patient disability in family communication. Sense of coherence was the only factor predicting positive emotions for both sexes. Support for spousal caregivers should be adjusted according to sex. A reduction in husbands' personal strain can alleviate their negative emotions, whereas wives' negative emotions can be relieved by improving communication within their families. Regardless of sex, a higher sense of coherence level has the potential to suppress negative emotions and enhance positive emotions.

Validation of the Zarit Burden Interview in Informal Caregivers of Patients with Severe Visual Impairment and Blindness.

The needs of family caregivers providing care to relatives with visual impairment are often dismissed, leading to caregiver burden. The Zarit Burden Interview (ZBI) can measure the caregiver burden of caring for a family member with vision impairment. The purpose of this study is to validate the ZBI in Mexican family caregivers of patients with visual impairment. The ZBI was applied to 137 family caregivers of patients with visual acuity ≤ 20/200 in the best eye for ≥ 6months. The ZBI's reliability was determined using Cronbach's α and the factor structure using exploratory factor analysis (EFA, principal axis factoring with promax rotation). Items with loadings < 0.400 were eliminated. Retained factors were determined using the scree test and Horn's parallel analysis (95%CI). Associations between burden factors and other variables were evaluated with descriptive and inferential statistics. Mean ZBI score was 26.2 ± 13.1, and internal consistency was high (α = 0.871). EFA yielded four factors: (1) embarrassment and frustration, (2) self-efficacy expectations, (3) interference in personal relationships, and (4) personal strain. The α values ranged from 0.649 to 0.812. Spousal caregivers had significantly higher scores (factors 1, 2, and 4), whereas adult children had less scores (factor3). There was a significant positive correlation between hours of daily caregiving and factors 2 (r = 0.350) and 3 (r = 0.388). A worse degree of visual impairment was associated with higher mean factor scores in all factors. The ZBI is a valid instrument to detect burden in Mexican caregivers of patients with visual impairment. We identified a four-factor structure that improved our understanding of the ZBI's underlying constructs. Interventions targeting specific types of burden are warranted.

Perception and coping with self-perceived burden among colorectal cancer patients and their caregivers: A qualitative study

PurposeSelf-perceived burden can take a toll on the physical and psychological well-being of cancer couples and prevent them from achieving favorable outcomes. There is limited qualitative research synthesizing the cognition and coping with self-perceived burden among Chinese colorectal cancer patients and their caregivers. Therefore, this study examined perceptions of self-perceived burden and coping strategies from the perspectives of colorectal cancer patients, their spousal caregivers and nursing staff. MethodsA qualitative study based on semi-structured interviews was implemented from May 15 to July 14, 2023. Data were analyzed using inductive thematic analysis. ResultsThis study summarized the cognition and coping strategies regarding self-perceived burden through three themes. Life under self-perceived burden contained sub-themes of Uncomfortable role changing, The handling of interpersonal relationships and Communication attitudes. What need to cope with contained sub-themes of Physical changes and discomfort, Negative emotions, Inappropriate decision-making and Negative communication. Coping with different perspectives contained sub-themes of Improving self-care ability correctly, Maintaining emotional stability, Finding new meaning and Solid family support. ConclusionsThe presence of self-perceived burden hinders good outcomes for colorectal cancer couples. It is necessary to help colorectal cancer couples cope with self-perceived burden together. Nursing staff need to be a bridge of communication and exchange for colorectal cancer couples, providing them with effective and reliable information and support, thus helping colorectal cancer patients and their spousal caregivers achieve true inner peace and better outcomes.

Resilience in Chinese Spouses of Patients with Advanced Cancer: A Longitudinal Exploration.

In China, spouses of patients with advanced cancer have reported experiencing psychological distress. However, little attention has been paid to the positive psychological health trajectories of these caregivers, particularly regarding their resilience and the factors influencing its development over time. To examine the trajectories of resilience in Chinese spousal caregivers over a nine-month post-treatment period and to identify the basic characteristics associated with these trajectory patterns. This was a longitudinal, observational study conducted in mainland Chinese between January 2022 and May 2024. A total of 306 spouses of patients receiving cancer treatment were recruited from five local hospitals. Data was collected in four waves: within one month of initial treatment, and then at three-, six-, and nine-month intervals post-treatment. Socio-demographic questionnaires, the Connor-Davidson Resilience Scale, and the Beliefs in Chinese Familism Scale were used to collect data. Growth mixture modeling was employed to determine the various trajectories of resilience, followed by logistic regression analysis to examine the associated factors to predict types of trajectories. Growth mixture modeling showed two distinct trajectories of resilience were identified: an increased group (N = 78, 25.5%) and a stable group (N = 228, 74.5%). The increased group began with a low baseline level (intercept = 46.713) and showed a slight increase over time (slope = 7.505, p < 0.001), while the stable group had a moderate baseline level (intercept = 56.565) and remained stable over time (slope = 0.068, p > 0.05). Those in the stable group were more likely to be female, and to have achieved a middle school level of education, a lower family income, and greater Chinese familism at baseline than those in the increased group. Our findings underscore the importance of tracking the trajectories of resilience and predictors of trajectory patterns among spouses caring for patients with advanced cancer within a specific cultural context. Healthcare providers should provide tailored interventions to enhance resilience in spousal caregivers, considering the trajectory patterns of mental health change.