Caregiver Communication Research Articles

Pola Komunikasi Hubungan Interpersonal Pengasuh Terhadap Anak Asuh Dalam Meningkatkan Kepercayaan Diri

Children who grow up in orphanages have the same rights as children who are in a family environment. Communication carried out by caregivers to provide motivation to foster children in terms of self-confidence. Based on this, orphanage caregivers need to carry out good communication patterns in increasing the confidence of foster children. The theory used in this study is the theory of social penetration popularized by Irwin Altman and Dalmas Taylor. This theory discusses the development of relationships through 4 stages, namely the orientation stage, the exploratory exchange stage, the affective exchange stage, and the stable exchange stage. This research uses a qualitative approach. Researchers use the constructivist paradigm, where knowledge is the result of human construction. Data collection techniques in this study through direct observation, in-depth interviews and documentation. The results showed that the pattern of communication of caregivers to foster children in increasing self-confidence in the Asyiyah orphanage was a wheel pattern, and a star pattern. The relationship between caregivers and foster children goes through 4 stages, namely the orientation stage, the exploratory exchange stage, the affective exchange stage, and the stable exchange stage. Factors that influence the increase in self-confidence in foster children are environmental factors and educational factors.

Resilience Communication Mitigates the Negative Relational Effects of Topic Avoidance: Evidence from Parental Caregiving and COVID-19 Pandemic Contexts.

Communicating about hardships with close others can be challenging, leading to avoidance of hardship-related topics. Although typically considered relationally damaging, topic avoidance could serve as a beneficial or neutral strategy when paired with relationally affirming communication. The current research investigates if the resilience communication processes outlined in the communication theory of resilience mitigate the negative relational effects of topic avoidance. Hypotheses are tested in two different contexts: sibling communication during parental caregiving (N=207) and spousal communication in the first months of the COVID-19 pandemic (N=598). The processes of crafting normalcy, communication networks, and productive action were beneficial across contexts. When participants reported higher engagement in these processes, topic avoidance was not significantly related to relationship satisfaction. At lower engagement levels, topic avoidance was negatively related to relationship satisfaction. Nuance between contexts existed. For example, humor moderated the effect of sibling caregiving topic avoidance but not spousal COVID-19 topic avoidance.

“Honour thy father and thy mother”: the meaning of integrating migrant live-in caregivers for elderly in the Haredi society - challenges and barriers to culturally-sensitive interventions

ABSTRACT Background and Purpose This study seeks to examine the complexities of integrating migrant live-in caregivers for elderly in the Haredi society from the lens of elderly’s family members. The main research questions were – what is the meaning of integrating migrant live-in caregivers for elderly in the Haredi society, and what are the implications of these meanings for developing policies and interventions? Materials and Methods This phenomenological study included 15 adult family members of elderly people from the Haredi society who receive around-the-clock homecare from migrant caregivers. Data was collected through in-depth, semi-structured interviews. Results Three themes emerged from the interviews: The motives of family members to become the prime caregivers for their parents; The encounter between the values of the Haredi family and migrant live-in caregivers; The commandment to honour one’s parents, and whether the integration of a migrant caregiver is implementing this commandment. Conclusions and Implications Results shed light on family members’ attitudes, perceptions and interactions in a phenomenon not yet explored. The importance of these results is highlighted considering the potential conflict between the Haredi society as a faith-based community and migrant live-in caregivers. The results could help develop a culturally-sensitive social policy for faith-based societies.

Balancing Quality, Intensity and Scalability: Results of a Multi-level Sexual and Reproductive Health Intervention for Very Young Adolescents in Kinshasa

PurposeIn addition to the rapid physical and cognitive transformations very young adolescents (VYAs) experience between ages 10–14, gender and social norms internalized during this period have long-term implications as adolescents become sexually active. This age presents critical opportunities for early intervention to promote gender-equitable attitudes and norms for improved adolescent health. MethodsIn Kinshasa, DRC, Growing Up GREAT! implemented a scalable approach to engage in- and out-of-school VYAs, caregivers, schools, and communities. A quasi-experimental study evaluated the outcomes of sexual and reproductive health (SRH) knowledge, assets and agency, and gender-equitable attitudes and behaviors among VYA participants. Ongoing monitoring and qualitative studies provided insights into implementation challenges and contextual factors. ResultsResults show significant improvement in SRH knowledge and assets such as caregiver connectedness, communication, and body satisfaction among the intervention group. The intervention was also associated with significant improvements in gender-equitable attitudes related to adolescents' household responsibilities and decreased teasing and bullying. Intervention effects on awareness of SRH services, body satisfaction, chore-sharing, and bullying were stronger for out-of-school and younger VYAs, suggesting the intervention's potential to increase positive outcomes among vulnerable adolescents. The intervention did not shift key gender norm perceptions assessed. Implementation research suggests design decisions made to increase the intervention's scalability necessitated reductions in training and program dosing that may have affected results. DiscussionResults affirm the potential of early intervention to increase SRH knowledge, assets and gender-equitable behaviors. They also highlight the need for more evidence on effective program approaches and segmentation for shifting VYA and SRH norms.

Satisfaction on patient related Communication by Healthcare Professionals among Caregivers of Patients Admitted in ICUs: A Descriptive Cross Sectional Study

Aim: A descriptive study was done to assess the satisfaction on patient related communication by healthcare professionals among caregivers of patients admitted in ICUs of a tertiary care hospital, Ernakulam. Background: Admission of a patient to an intensive care unit (ICU) can result in tremendous stress to family caregivers not only because of the need to provide physical and emotional support to the sick relative, but also due to the burden of decision-making on behalf of the critically ill person. When acute illness leads to admission to an intensive care unit (ICU), the patient's dependence for assistance increases several-fold and much of this burden falls on the family caregiver. Communication practices of multiple professionals in health care settings can impact patient outcomes. The purpose of this study was to assess caregiver’s satisfaction on patient related communication by healthcare professionals and also to study the difference in the caregiver satisfaction on patient related communication by different category of health care professional. Methods: A descriptive study was conducted among caregivers of patients admitted in the ICUs of a tertiary care hospital. By using convenient sampling technique 100 caregivers were enrolled to the study and the data was collected by self-report techniques by using structured communication satisfaction assessment scale for doctors and nurses. Results: Data were analyzed by using descriptive and inferential statistics presented in tables, bar diagrams. Significant difference (p=0.01) was observed in the score obtained for communication satisfaction for doctors 61(60, 63) and nurses 59.5(58, 61). Conclusion: The findings of the present study highlights that the caregiver communication satisfaction was higher with doctors than other health care professionals.

Diffusion of a micronutrient home fortification program for infants and toddlers in a multi-ethnic population in rural western China

BackgroundThe micronutrient home fortification programs contribute to the prevention of childhood anemia. WHO suggested applying culturally appropriate strategies to implement the micronutrient home fortification programs in various communities. However, there is little knowledge on evidence-based effective diffusion strategies of the micronutrient home fortification programs in multi-ethnic populations. This study aims to examine the diffusion of a micronutrient home fortification program with micronutrient powder (MNP) in a multi-ethnic population by investigating factors associated with being an ‘early’ or a ‘later’ adopter of MNP.MethodsWe conducted a cross-sectional study in rural western China. Multistage sampling was used to select children’s caregivers in Han, Tibetan, and Yi ethnic communities (N = 570). The diffusion of innovations theory informed the data collection on caregivers’ decision process and was applied to classify participants into the MNP adopter categories of ‘leaders’, ‘followers’, ‘loungers’, and ‘laggards’. The ordered logistic regression model estimated the factors associated with the MNP adopter categories.ResultsCaregivers from the Yi ethnic subgroup were likely to adopt MNP relatively late (AOR = 1.67; 95%CI = 1.09, 2.54) compared with Han and Tibetan ethnic subgroups. Caregivers with more knowledge regarding the MNP feeding method (AOR = 0.71; 95%CI = 0.52, 0.97) and those with stronger self-efficacy in adopting MNP (AOR = 0.85; 95%CI = 0.76, 0.96) were more likely to adopt MNP earlier than others. The following messages and channels also tend to make caregivers adopt MNP earlier: hearing that ‘MNP was free’ from villagers (AOR = 0.45; 95%CI = 0.20, 0.98), and learning ‘MNP feeding method’ from township doctors (AOR = 0.16; 95%CI = 0.06, 0.48).ConclusionsDisparities in adopting MNP existing among different ethnic groups require more effective diffusion strategies in disadvantaged minority ethnic groups. Enhancing self-efficacy in adopting MNP and knowledge on feeding method of MNP have the potential to make caregivers adopt MNP earlier. Peer networks and township doctors can be effective agencies to facilitate the diffusion and adoption of MNP.

Cultivating Relationship-Centered Care: Patient, Caregiver, and Provider Communication Preferences for and Experiences with Prognostic Conversations

ABSTRACT Prognostic conversations present many challenges for patients, caregivers, and providers alike. Most research examining the context of prognostic conversations have used a more siloed approach to gather the range of perspectives of those involved, typically through the lens of patient-centered care. However, the mutual influence evident in prognostic conversations suggests a relationship-centered care model may be useful in cancer communication research. Similarities and differences in preferences for and experiences with prognostic conversations among oncology patients, caregivers, and providers (N = 32) were explored. Identified themes were then mapped to the principles of the relationship-centered care framework to extend our understanding of prognostic conversations and contribute to a new direction in the application of relationship-centered care. Findings suggest fewer similarities than differences, point to important discrepancies among participant perspectives, and reinforce the utility of relationship-centered care in identifying communication practices that enhance the prognostic conversation experience.

STRATEGI KOMUNIKASI PENGASUH DALAM MEMBENTUK KARAKTER RELIGIUS ANAK PADA PANTI ASUHAN DHARMA WIDYA KUMARA KELURAHAN KUBU KABUPATEN BANGLI

Based on this background, researchers are interested in researching related to "Caregiver Communication Strategies in Forming the Religious Character of Children at the Dharma Widya Kumara Orphanage, Kubu Village, Bangli Regency", with the formulation of the problem, namely 1) What is the communication strategy used by caregivers in shaping the religious character of children? 2) What are the obstacles and efforts made by caregivers in using communication strategies to shape the religious character of children? 3) What is the impact of the communication strategy used by caregivers in shaping the religious character of children? The theory used in this research is interpersonal communication theory, communication barrier theory, S_O_R (Stimulus-Organism-Response) theory. This study uses a qualitative approach. This type of data collection is qualitative from primary and secondary data sources. Data collection techniques used are observation, interviews, documentation.The findings of the research are: 1) The communication strategies applied by caregivers in shaping the religious character of children at the Dharma Widya Kumara Orphanage, Kubu Village, Bangli Regency are persuasive communication strategies,coercive communication strategies and redundancy (reputation) communication strategies. 2) Obstacles in implementing communication strategies by caregivers in forming the religious character of children at the Dharma Widya Kumara Orphanage, Kubu Village, Bangli Regency, have internal and external obstacles. 3) The impacts arising from the communication strategy applied by caregivers in shaping the religious character of foster children at the Dharma Widya Kumara Orphanage, Kubu Village, Bangli Regency are: changes in the quality of children from the cognitive aspect, changes in the quality of children from the affective aspect, changes in the quality of children from the psychomotor aspect.

Building Death Literacy Through Last Aid: An Examination of Agency, Ambivalence and Gendered Informal Caregiving Within the Swedish Welfare State

ABSTRACT In the last two decades, health promotion strategies have gained significant attention in end-of-life care contexts—engendering greater focus on community and informal care in policy and healthcare spheres in liberal welfare-states. The emergence of health-promoting palliative care (HPPC) in the Nordic context presents a unique challenge to the abiding social contract of care which emphasizes the de-familialisation of child- and long-term care. This study reflects upon the implementation of one HPPC inspired educational initiative, called Last Aid, into a Swedish context and its influence on social relations of care within the welfare state model. Participants articulated Last Aid as a tool which helped them reclaim agency amidst the inertia of competing norms and expectations of informal caregiving. These findings indicate that the implementation of Last Aid into the Swedish context is characterized by a tension between norms of institutional caregiving versus community caregiving, representing a case of sociological ambivalence. Furthermore, the data shows that women disproportionately perform informal caregiving for seriously ill significant others in an institutional context where state care services are diminishing. Employing a feminist analytical approach, these results, and the HPPC perspective, are discussed in light of trends towards welfare retrenchment in the Nordic countries.

Mission-minded pastoral theology and the notion of God’s power: Maturity through vulnerability

This article contributed to constructive missional theology by grappling with the issues of God’s power and Christian maturity. This is important, because we live in a wounded world fraught with injustice, violations of human dignity, and power abuse. Pastors and other caregivers are called to be involved with caring for people to promote more just societies where human dignity flourishes. Such caring practices form a crucial and practical part of the human embodiment of God’s loving mission in our wounded living spaces. The main research question that was addressed, is as follows: How can pastoral theology be directed by a missional understanding of the church so that it can become clear how caring practices embody the missio Dei? Considering this question, this article explicated what kind of theology is appropriate when mission-minded Christian caregivers want to interpret God’s power in a fractured world. The author indicated – through a careful and methodical literature study – that the recovery of a missional, trinitarian understanding of God, offers fresh resources for reconceptualising spiritual formation, focusing on mission as authentic discipleship. While unravelling this article’s main argument, it was deemed of paramount importance to harmonise our ideas about the power of God, because such notions (about God’s power) often dictate how we act within human relationships, which are also replete with power. It was concluded that preference needs to be given to viewing ‘power as love’ (vulnerability) rather than ‘power as force’ (control). Eventually the analysis of relevant literature resources indicated that pastoral care done in congregations, does not merely find its end goal in strengthening believers to grow into maturity in Christ, but also fosters our missional calling as sent disciples of the triune God. In addition, Christian faith maturity was found to be essential if pastoral theology and pastoral care practices – mostly performed by pastors or other caregivers in faith communities – aim to promote justice and human dignity as integral part of the missio Dei.Contribution: The dearth of consideration for the vital issue of Christian maturity presents a challenge for the field of mission studies, when pastoral theology and care practices engage with views regarding God’s power. The rigorous literature study contributed constructive insights for missional churches that value God’s justice and dignity to all.

A qualitative study of the interaction experiences between family caregivers and community nurses for disabled elderly people at home

BackgroundFamily members are currently the main caregivers of the disabled elderly people at home. With declining health and increasing frailty, caregiving of disabled elderly people becomes a task of family caregivers in conjunction with community nurses. Interaction between family caregivers and community nurses can effectively improve the quality of home care for the disabled elderly people. This study aimed to investigate the interaction experiences between family caregivers and community nurses for disabled elderly people at home.MethodsThis research was a study of qualitative descriptions based on semi-structured face-to-face interviews. This study was to purposefully select family caregivers of the disabled elderly and community nurses in Zhengzhou city, Henan Province and explore the interaction patterns between them. Directed content analysis method was used to generate qualitative codes and identify themes.ResultsA total of 12 interviews were completed, including 7 family caregivers and 5 community nurses. Four themes were identified: 1) Information interaction; 2) Emotional interaction; 3) Practical interaction; 4) Factors that promote and hinder the interaction.ConclusionsIt was found that the interaction between family caregivers and community nurses was not optimistic. Lack of communication and collaboration between community nurses and caregivers. Providing a new perspective that we can develop and implement intervention to facilitate positive interactions, which will reduce the burden of family caregivers, bring the highest quality of care to older adults with disabilities and improve the quality of care for disabled elderly people.Trial registrationRegistered in the Chinese Clinical Trial Registry on April 19, 2021, number ChiCTR2100045584.

Caregivers perception of common neonatal illnesses and their management among rural dwellers in Enugu state, Nigeria: a qualitative study

BackgroundNeonatal mortality continues to be a challenge in Nigeria, where low-quality care, caregivers’ ignorance of signs of neonatal illnesses, and prevalent use of unorthodox alternatives to health care predominate. Misconceptions originating and propagating as traditional practices and concepts can be linked to adverse neonatal outcomes and increased neonatal mortality. This study explores the perceptions of causes and management of neonatal illness among caregivers in rural communities in Enugu state, Nigeria.MethodsThis was a cross-sectional qualitative study among female caregivers of children residing in rural communities in Enugu state. A total of six focus group discussions (FGDs) were conducted; three in each of the communities, using an FGD guide developed by the researchers. Using pre-determined themes, thematic content analysis was used to analyze the data.ResultsThe mean age of respondents was 37.2 ± 13.5 years. Neonatal illnesses were reportedly presented in two forms; mild and severe forms. The common causes of the mild illnesses reported were fever, jaundice, eye discharge, skin disorders, and depressed fontanelle. The severe ones were convulsion, breathlessness/difficulty or fast breathing, draining pus from the umbilicus, and failure-to-thrive. The caregivers’ perceptions of causes and management of each illness varied. While some believed these illnesses could be managed with unorthodox treatments, others perceived the need to visit health centers for medical care.ConclusionsCaregivers’ perception on the causes and management of common neonatal illnesses in these communities is poor. Obvious gaps were identified in this study. There is a need to design appropriate interventions to dispel the myths and improve the knowledge of these caregivers on neonatal illnesses towards adopting good health-seeking behaviours.

Feedback from clinical psychologists on the online version of the Communication and Interaction Training (CAIT) package

The Communication and Interaction Training (CAIT) programme is a six module package designed to enhance caregiver communication skills. It builds on, and extends, caregivers‘existing skills in managing behaviours that challenge (BtC) in dementia care. An on-line version of the training was produced between 2020-2022, during the Covid-19 pandemic, to enhance the delivery of CAIT, and to further support caregivers’ good practice. To aid the development of on-line CAIT a number of pilot sessions were organised to obtain feedback on the package. This article provides data from the first of these pilots.Feedback was obtained from 16 clinical psychologists who attended a 5.5 hour workshop on CAIT. Satisfaction ratings for the modules varied between 87–96 per cent. Qualitative feedback was analysed using thematic analysis, and four key themes emerged: (i) Applicability in practice, (ii) Delivery and visual learning, (iii) Consolidation of content, (iv) Implementation of package. The overall analyses showed CAIT to be a well delivered and highly applicable training programme for staff working in dementia care. Specfic recommendations were made to improve CAIT, particularly in relation to its on-line delivery.

Perspectives on quality of life among disability-related organization leaders serving individuals with paralysis

Understanding how the Christopher & Dana Reeve Foundation Quality of Life grant recipients define quality of life has value in helping to further develop and refine the literature on this topic for individuals with spinal cord injury and/or organizations working to serve and/or support individuals with spinal cord injury. The purpose of this organizational evaluation project’s evaluation activities was to engage with Quality of Life (QOL) Grant recipients, namely leaders at disability-related organizations across the United States, to better understand their definitions and operationalization of the term, “quality of life”. To do so systematically, researchers compiled a list of all QOL grant recipients from two 2016 grant cycles and divided them into three categories based on the award amount. From these categories, we randomly selected organizations to invite to provide input. Phone interviews were completed with 19 grant recipients. A thematic content analysis was completed across the resulting transcripts using MAXQDA software. The sub-themes identified by researchers included: community connection, independence, self-determination, caregiver communication, and including caregivers in programs. Our analysis demonstrates the importance of both community and caregiver relationships to organizations that focus on QOL for people with SCI. Novel findings suggest the importance of community and connection as well as a reframing of both the constructs of independence and control within QOL. Lessons for evaluators are also provided.

Three Perspectives on the Experience of Support for Family Caregivers in First Nations Communities.

There is a dearth of research on how family caregivers are supported in First Nations. We interviewed family caregivers, health and community providers, and leaders in two Alberta First Nations Communities about their experiences of care and support for the family caregivers in their communities. We employed a qualitative, collaborative participatory action research methodology. We drew on Etuaptmumk, the Mi'kmaw understanding of being in the world is the gift of multiple perspectives. Participants in this research included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). The overarching caregiving theme is the "Hierarchy of challenge". Six themes capture the challenges faced by family caregivers: (one) "Caregiving is a demanding job": yet "No one in a sense is taking care of them"; (two) difficult navigation: "I am unable to access that"; (three) delayed assessments and treatment "And I don't know how they're being missed"; (four) disconnected health records: "It's kind of on you to follow up"; (five) racism, "It's treated differently"; and, (six) social determinants of health, "A lot of these factors have been developing for the longest time". This study provides evidence that family caregivers' need to care for and to maintain their own wellbeing is not top of mind in policy or programs in these First Nations communities. As we advocate for support for Canadian family caregivers, we need to ensure that Indigenous family caregivers are also recognized in policy and programs.

Human resource time commitments and associated costs of Community Caregiver outreach team operations in South Africa.

In South Africa, Community Caregivers (CCGs) visit households to provide basic healthcare services including those for tuberculosis and HIV. However, CCG workloads, costs, and time burden are largely unknown. Our objective was to assess the workloads and operational costs for CCG teams operating in different settings in South Africa. Between March and October 2018, we collected standardized self-reported activity time forms from 11 CCG pairs working at two public health clinics in Ekurhuleni district, South Africa. CCG workloads were assessed based on activity unit times, per-household visit time, and mean daily number of successful household visits. Using activity-based times and CCG operating cost data, we assessed CCG annual and per-household visit costs (USD 2019) from the health system perspective. CCGs in clinic 1 (peri-urban, 7 CCG pairs) and 2 (urban, informal settlement; 4 CCG pairs) served an area of 3.1 km2 and 0.6 km2 with 8,035 and 5,200 registered households, respectively. CCG pairs spent a median 236 minutes per day conducting field activities at clinic 1 versus 235 minutes at clinic 2. CCG pairs at clinic 1 spent 49.5% of this time at households (versus traveling), compared to 35.0% at clinic 2. On average, CCG pairs successfully visited 9.5 vs 6.7 households per day for clinics 1 and 2, respectively. At clinic 1, 2.7% of household visits were unsuccessful, versus 28.5% at clinic 2. Total annual operating costs were higher in clinic 1 ($71,780 vs $49,097) but cost per successful visit was lower ($3.58) than clinic 2 ($5.85). CCG home visits were more frequent, successful, and less costly in clinic 1, which served a larger and more formalized settlement. The variability in workload and cost observed across pairs and clinics suggests that circumstantial factors and CCG needs must be carefully assessed for optimized CCG outreach operations.

The Brother–Sister Sibling Dyad as a Pathway to Gender-Based Violence Prevention: Engaging Male Siblings in Family-Strengthening Programs in Humanitarian Settings

Household violence poses a significant threat to the physical and mental health of adolescent girls. In conflict-affected communities, increased stresses to safety, security, health, and livelihoods may heighten this risk. While it is widely evidenced that the caregiver-child relationship can increase or protect against girls’ risk of violence, less is known about the role of male siblings. Sibling Support for Adolescent Girls in Emergencies (SSAGE) used whole-family support programming to synchronously engage adolescent girls, their male siblings, and their caregivers in conflict-affected communities in Jordan and Niger, using gender-transformative approaches to explore the impacts of gender norms, power, and violence and encourage support and emotional connection. We conducted qualitative research activities, including focus group discussions, participatory group activities, and in-depth, paired, and key informant interviews with 469 SSAGE participants and program facilitators to explore SSAGE’s impact on the male-female sibling dyad in both settings. The multi-stakeholder team used a collaborative thematic analysis approach to identify emergent themes. Findings suggest that the inclusion of male siblings in family strengthening programs may have a positive impact on factors related to girls’ protection, with research participants discussing decreased perpetration of physical and verbal violence by male siblings, increased equity in household labor between siblings, and improved trust and mutual support among siblings. These changes were facilitated by improved communication and interrogation of positive gender identities. In humanitarian settings, interventions that support more gender-transformative, egalitarian, and emotionally effective relationships between male-female siblings can work towards improving girls’ protective assets. More research on the impact of this relationship on girls’ experience of immediate and long-term experience of violence is needed. In settings where gender power dynamics among male-female siblings are less salient, other relationship dyads should be explored.

Perception of the factors contributing to family happiness among caregivers of stroke survivors in a suburban community in Thailand: A qualitative study.

Caring for stroke survivors in primary care settings substantially impacts family life and health. Caregivers of stroke survivors have different challenging experiences in providing care in relation to family happiness. This study aimed to explore family happiness and its contributing factors among family members caring for stroke survivors in suburban Thailand. Qualitative semi-structured interviews and observations were conducted among 54 family caregivers in suburban Thailand communities from January to July 2020. Interviews and focus group discussions were digitally recorded, independently transcribed and analysed using ATLAS.ti 8.0. Qualitative data analysis method was used. Family happiness was found to help a family function and be satisfied with caring. The analysis revealed three themes for achieving family happiness: 1) ideal caregiver characteristics: virtue, love and gratitude, experience in caring, good health and self-care ability, good management of emotions and freedom to manage problems and obstacles; 2) family function: family structure, roles and duties, relationships and management of family problems; and 3) resource support: financial, health and environmental supports. The findings demonstrate how life adaptations can improve family happiness within families of stroke survivors. Understanding caregivers' perceptions of their experiences in caring for stroke survivors is a challenge for healthcare providers; overcoming this could transform an unpleasant life into caregiving happiness. Appropriate and practical support from healthcare authorities could empower families of stroke survivors to succeed in caregiving and achieve family happiness.

Cancer patient and caregiver communication about economic concerns and the effect on patient and caregiver partners' perceptions of family functioning.

Financial strain and stressful life events can constrain open communication within families. A cancer diagnosis can bring heightened emotional stress and financial strain for most cancer patients and their families. We evaluated how level of comfort and willingness to discuss important but sensitive economic topics affected longitudinal assessments of family relationships, exploring both within-person and between partner effects over 2years after a cancer diagnosis. A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2years. Multi-level models were developed to examine the associations between comfort discussing economic aspects of cancer care and family functioning. Broadly, caregivers and patients who were comfortable discussing economic topics reported higher family cohesion and lower family conflict. Dyads' assessments of family functioning were influenced both by their own and their partners level of communication comfort. Overtime, caregiver but not patients perceived a significant decrease in family cohesion. Efforts to address financial toxicity in cancer care should include examination of how patients and families communicate as unaddressed difficulties can have detrimental effects on family functioning in the long term. Future studies should also examine whether the prominence of specific economic topics, such as employment status, varies depending on where the patient is in their cancer journey. In this sample, cancer patients did not perceive the decline in family cohesion that was reported by their family caregiver. This is an important finding for future work that aims to identify the timing and nature to best intervene with caregiver supports to mitigate caregiver burden that may negatively impact long-term patient care and QoL.

Anticancéreux oraux : retour d’expérience après six années de consultations tripartites dans un centre hospitalier

Tripartite consultations with a coordination between hospital and community care givers were implemented within hospital center for patients who start an oral anticancer regimen. Six years after the implementation, we wanted to assess this patient's pathway and describe how adjustments were necessary over the time. A total of 961 patients received tripartite consultations. The medication review process revealed that nearly half of patients had polypharmacy (≥5 drugs/day). A pharmaceutical intervention was formulated in 45% of cases and they were all accepted. For 33% of patients, a drug interaction was identified and required for 21% of them, discontinuation of one drug of their personal treatment. Coordination with general practitioner and community pharmacists were achieved for all patients. 390 patients benefitted from nursing telephone follow-up which represents approximately 20 calls per day to assess tolerance and compliance with treatments. Over time, organisational adjustments were necessary to adapt to the increase in activity. The scheduling of consultations has been improved thanks to the creation of a shared agenda and consultation reports have been expanded. Finally, an hospital functional unit was created to facilitate the financial valuation of this activity. The feedback collected from the teams showed a real desire to perpetuate this activity even if it would seem that an improvement in human resources is still relevant as well as a better optimisation of the coordination between all the participants.