Developmental Burden Research Articles

Marital satisfaction ofChinese mothers of children with autism and intellectual disabilities inHongKong

Previous research showed an association among perceived stigma, perceived caregiving burden and marital satisfaction of mothers. However, little is known about their relationship among mothers of young children with disabilities in the Chinese context. The mediating role of perceived caregiving burden between perceived stigma and marital satisfaction was seldom explored. Hence, the present study aims to investigate the relationship between perceived stigma, perceived caregiving burden and marital satisfaction of Chinese mothers of children with intellectual disabilities or autism spectrum disorders in Hong Kong. A cross-sectional survey using convenience sampling was conducted with mothers of pre-school children with disabilities aged from 2 to 6. A total of 160 completed questionnaires were collected from five special child care centres in Hong Kong. The findings in the hierarchical regression analyses showed that perceived stigma and perceived caregiving burden were significant predictors of mothers' marital satisfaction. Perceived burden, including perceived social burden, emotional burden and developmental burden but excluding time-dependence and physical burden, were found to be significant mediators between perceived stigma and marital satisfaction. To address the negative consequences brought on by stigma, measures can be taken to prevent stigmatisation and minimise the harmful effects. To alleviate mothers' perceived burden, Acceptance and Commitment Therapy, mutual support groups and psycho-educational and skills training programmes can be conducted for the mothers.

“Caring for One's Own”: Variation in the Lived Experience of African-American Caregivers of Elders

This study provides in-depth, descriptive data on the caregiving context and indicators of caregiving stress, rewards, and resources reported by 300 African-American family caregivers of elders residing in the community. Findings revealed generally high levels of caregiving intensity in terms of types of assistance given and hours of caregiving provided. On average, participants reported moderate levels of time-dependence, developmental, and financial burden, but relatively low levels of social and physical burden and emotional and relationship distress. Caregivers also reported high levels of caregiving rewards, including meaning, purpose, and connection/attachment to the care recipient. In terms of resources, both informal and formal levels of support were generally low, while religion/spirituality emerged as an important resource for the majority of the sample. Finally, findings show higher levels of approach versus avoidant coping strategies. Although some commonalities among participants were noted in these areas, close examination of the dispersion of scores in all areas reveals a multifaceted and diverse picture of the caregiving experience, suggesting caution against oversimplification or reliance on general assumptions when providing services to African-American caregivers. This article concludes with four key implications for effective and culturally sensitive social work practice with this heterogeneous population and notes directions for future research.

Correlation between components of tolerance caregivers in Jahrom hospitals using factor analysis

AbstractBackground and aim: Nurses have an important role in caring of clients. So, determine the component of identifying structure of components and correlation between them can effective in determine the new component and identifying the effective factors of burden. The aim of current study is to determine the correlations between CBI components among nurses in Jahrom hospitols by using factor analysis.Materials and methods: In this research, 158 of nurses in Jahrom hospitals with stratified sampling enrolled to study. by using car-giver ills questionnaire, five burden’s components that involve dependence burden, Developmental burden, burden, Social burden and burden were assessed. Data were analyzed by Pierson correlation coefficient, regression models and factor analysis.Results: Time dependence Developmental Physical Social and Emotional of women were significantly higher than men (p<0.05). There was a significant difference between workplace and different components (p<0.05). Time dependence of CCU nurses and triage nurses were in a high and low level, respectively. There was a significant correlation between Emotional and Social (P=0.000). Factor analysis showed that nurse's contains two main factors, that these two factors predicting 64% of total data variance. According to factor analysis physical burdens and Developmental and Physical were an independent factor, social and emotional burdens were another independent factor.Conclusion: There was a significant difference between gender and workplace with components of Burden. Women’s Burden in caring of patients was more than men which can related to physical and emotional characteristics of women.Key words: Time dependence Developmental Physical Social Emotional Factor Analysis

Predictive Role of Different Dimensions of Burden for Risk of Complicated Grief in Caregivers of Terminally Ill Patients

The aim of the study was to test whether high levels of caregiver burden, as other confirmed predictors, are associated with the risk of prolonged grief disorder in caregivers of terminally ill patients. A predictive study was carried out in order to test the hypothesis. A demographic schedule, the Prolonged Grief 12 (PG-12), the Toronto Alexithymia Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Caregiver Burden Inventory were administered to 60 caregivers of 51 patients who were admitted in Hospice. In the regression analysis, difficulty in recognizing emotions, total burden, depression, and developmental burden dimension were significant predictors of PG-12 levels. Findings showed that feeling of deprivation of existential expectations represents the greater risk factor for the prolonged grief disorder, among the burden dimensions.

Caring burden and associated factors of care providers for senile dementia patients in an urban-rural fringe of Fuzhou City, China.

Dementia is a serious disease that places undue burden on family care providers. This study aimed to investigate caring burden and associated factors of care providers for dementia patients in an urban-rural fringe area in China. A total of 197 dementia patients ≥65 years of age were identified from July-November 2007 in 22 villages of Gushan Town, Fuzhou City, China, and 152 care providers of the patients were recruited and analyzed. The Care Provider Burden Inventory was used to evaluate the main burdens including overall burden and time-dependent, developmental, physical, emotional and social burdens. Factors associating with caring burden were analyzed. The prevalence rate of dementia was 7.3% (197/2696) in study area. Four factors significantly increased overall care providers' burden score: daily hours of caring time, payment source for patients' medical expense, care providers' religion and care providers' role awareness (adjusted-R2 0.617). Patients with significantly impaired function of daily living (higher ADL scores) resulted in a higher caregivers' time-dependent burden. Increasing hour of caring per day increased care providers' time-dependent, physical and developmental burden. Care providers' view of their role awareness as obligation increased score of time-dependent, developmental, physical and emotional burdens. Patient with physical disability significantly increased developmental, physical, emotional and social burdens. The main influence factors of the caring burden of care providers' for dementia patients were length of daily caring hours, source of care receivers' medical expenses, patient with physical disability and care providers' role awareness (i.e., obligated vs willing).

Caregiver burden and related factors in caregivers of children with autism

Objective To investigate the level of caregiver burden of primary caregivers of children with autism, and explore the factors related to caregiver burden. Methods 177 caregivers of children with autism were tested with caregiver burden inventory(CBI)and childhood autism rating scale(CARS). A cross-sectional and multisite study design was used. Results The scores of caregiver burden was (57.50±14.91), and time-dependence burden and developmental burden were the most serious domains.Caregiver burden was affected by caregiver's age, caregiver's religious beliefs, caregiver's marital status, caregiver employment status and education degree and children's scores of CARS and degree of CARS(-0.151≤r≤0.282, P<0.05). Conclusion The data suggest that community care workers should pay attention to caregivers of children with autism and give them personalized health education and intervention according to the demographic characteristics of the caregivers and the severity of children disease. Key words: Autism; Children; Caregivers; Caregiver burden

Evolution of Growth Habit, Inflorescence Architecture, Flower Size, and Fruit Type in Rubiaceae: Its Ecological and Evolutionary Implications

During angiosperm evolution, innovations in vegetative and reproductive organs have resulted in tremendous morphological diversity, which has played a crucial role in the ecological success of flowering plants. Morindeae (Rubiaceae) display considerable diversity in growth form, inflorescence architecture, flower size, and fruit type. Lianescent habit, head inflorescence, small flower, and multiple fruit are the predominant states, but arborescent habit, non-headed inflorescence, large flower, and simple fruit states occur in various genera. This makes Morindeae an ideal model for exploring the evolutionary appearances and transitions between the states of these characters. We reconstructed ancestral states for these four traits using a Bayesian approach and combined nuclear/chloroplast data for 61 Morindeae species. The aim was to test three hypotheses: 1) self-supporting habit is generally ancestral in clades comprising both lianescent and arborescent species; 2) changes from lianescent to arborescent habit are uncommon due to “a high degree of specialization and developmental burden”; 3) head inflorescences and multiple fruits in Morindeae evolved from non-headed inflorescences and simple fruits, respectively. Lianescent habit, head inflorescence, large flower, and multiple fruit are inferred for Morindeae, making arborescent habit, non-headed inflorescence, small flower, and simple fruit derived within the tribe. The rate of change from lianescent to arborescent habit is much higher than the reverse change. Therefore, evolutionary changes between lianescent and arborescent forms can be reversible, and their frequency and trends vary between groups. Moreover, these changes are partly attributed to a scarcity of host trees for climbing plants in more open habitats. Changes from large to small flowers might have been driven by shifts to pollinators with progressively shorter proboscis, which are associated with shifts in breeding systems towards dioecy. A single origin of dioecy from hermaphroditism is supported. Finally, we report evolutionary changes from headed to non-headed inflorescences and multiple to simple fruits.

Difficulty and burden experienced by principal family caregivers of people with intellectual disabilities in Hong Kong

We attempted to depict the characteristics of the difficulty and burden experienced by people caring for a family member with mental retardation in Hong Kong and to determine whether caregiving difficulty and burden should be conceptualized as unidimensional or multidimensional concepts. The Caregiving Difficulty Scale (CDS) and Caregiver Burden Inventory (CBI) were administered to 992 primary caregivers recruited from 63 service units of eight local nongovernmental organizations across all districts of Hong Kong. The factor analyses of the CDS and CBI items resulted in multiple-factor rather than single-factor models, and there were significant differences between the factor scores for both the CDS and CBI. In particular, physical caring was perceived to be significantly more challenging than social caring and daily caring. Similarly, time-dependence burden was more severe than developmental, physical, social and emotional burden. Moreover, the factor scores of the CDS and CBI were differentially modulated by the types of social services that the participants received. The overall findings highlight the importance of conceptualizing caregiver burden as a multidimensional construct in both clinical research and practice.

Childhood blood lead levels and intellectual development after ban of leaded gasoline in Taiwan: A 9-year prospective study

BackgroundLead (Pb) exposure is associated with children's neurodevelopment, even at low doses. Leaded gasoline was banned in Taiwan in 2000 to reduce environmental exposure to Pb. ObjectivesTo evaluate the neurodevelopmental effect of low-level Pb exposure in young children. MethodsIn 2001–2002, we have recruited 430 pregnant women in the third-trimester in Taichung, Taiwan who answered detailed questionnaires in the obstetric clinic. A total of 119, 76, and 66 children were followed up at 2–3, 5–6 and 8–9years, respectively. We collected blood samples from pregnant women, Umbilical cord and children, and evaluated children's neurodevelopment and cognition function at all three time points using Bayley and Wechsler tests. Blood samples were analyzed for whole blood lead (BPb) levels. ResultsGeometric mean of BPb in pregnant women, cord blood and children at 2–3, 5–6 and 8–9years old were 2.21, 1.30, 2.48, 2.49 and 1.97μg/dl, respectively. Low-level postnatal Ln BPb was significantly associated with not only decreasing intelligence quotient (IQ), but also delayed cognitive function in children at 5–8years (β: −5.97, SE: 2.59, p=0.025), after adjustment for maternal education, maternal BPb exposure, Home Observation for Measurement of the Environment Inventory (HOME), and gender of child, using linear mixed models. No significant relation was observed between prenatal and cord blood Pb levels and children's cognitive function in children 2–8years. ConclusionsLow-level postnatal BPb levels in children at 2–5years may have lagged effects on neurodevelopment in those at 5 to 8years. Action is warranted to reduce even very low environmental Pb levels to reduce the developmental burden of Pb on children.

Caregiver Burden and Coping in Early-stage Alzheimer Disease

This study was set out to describe caregiver-perceived burden and coping in early-stage Alzheimer disease (AD). A total of 163 consecutive pairs of patients with AD and their principal caregivers were initially recruited. The caregivers completed the Caregiver Burden Inventory (CBI) and the Coping Orientations to Problems Experienced scale, and also provided sociodemographic information; the patients with AD were assessed by means of the Mini Mental State Examination and the Neuropsychiatric Inventory. Data from 126 patient-caregiver pairs were analyzed. The caregivers (mean age 56.11±12.37 y) were mainly women (76%); 64% were the patient's offspring; 39% lived with the patient. From the CBI data, it emerged that caregivers perceived loss of personal time (objective burden, 33%) and the feeling of missing out on opportunities (developmental burden, 25%) as their main stressors. Total CBI score was negatively correlated with Mini Mental State Examination (P=0.005). As regards coping strategies, the caregivers predominantly used problem-oriented strategies associated with a positive attitude. The use of dysfunctional strategies was predictive of caregiver burden. It is important to be aware that avoidance and dysfunctional coping strategies predispose caregivers of patients with AD to higher level of distress, whereas successful caregiving seems to be based on the use of problem-oriented strategies early in the disease when solutions are still available.

Domain-Specific Associations between Burden and Mood State in Dementia Caregivers

Research indicates that caregiver burden is related to caregiver mood state. The current study investigated the relationship between caregiver burden and affect via the Caregiver Burden Inventory and the Profile of Mood States. The sample was comprised of 31 female caregivers of individuals with dementia. Regression analyses revealed that developmental burden predicted caregiver tension-anxiety, and along with time dependence burden (an inverse predictor), was predictive of caregiver depression-dejection. Social burden emerged as a predictor of caregiver anger-hostility and confusion-bewilderment, and in conjunction with physical burden it predicted caregiver fatigue-inertia. The current findings are reviewed with regard to treatment implications.

Caregivers burden and needs in community neurorehabilitation

The aim of this study was to analyse the burden on caregivers of chronic neurological patients taking part in community neurorehabilitation programmes, and to describe caregivers' socio-demographic features and needs. A total of 118 pairs of chronic neurological patients and their caregivers. Caregivers completed the Caregiver Burden Inventory, the Beck Depression Inventory, and an ad hoc socio-demographic questionnaire. The EuroQol-5D was used to measure patients' quality of life. Patients' cognitive status and functional independence status were assessed using the Mini-Mental State Examination and Barthel Index, respectively. Data from 105 patient-caregiver pairs were analysed. The majority of caregivers (mean age 63.01 ± 12.3 years) were women (58%); 72% were spouses/partners. The burden of care was distributed across the 5 domains of the Caregiver Burden Inventory as follows: objective burden (34%), developmental burden (25%), physical burden (22%), social burden (10%), emotional burden (9%). Care burden correlated negatively with patient's functional independence (p = 0.008) and quality of life (p = 0.000) and positively with caregiver depression (p = 0.000). Of the caregivers, 65.7% requested interventions aimed at reducing their burden. There is a need to define structured interventions for assessing, preventing or managing problems related to stressful caregiving situations across the care continuum.

Primitive versus derived traits in the developmental program of the vertebrate head: views from cyclostome developmental studies

Evolution can be viewed as a series of changes in the developmental program along the phylogenetic tree. To better understand the early evolution of the vertebrate skull, we can use the embryos of the cyclostome species as models. By comparing the cyclostome developmental patterns with those of gnathostomes, it becomes possible to distinguish the primitive and derived parts of the developmental program as taxon-specific traits. These traits are often recognizable as developmental constraints that define taxa by biasing the developmental trajectories within a certain limited range, resulting in morphological homologies in adults. These developmental constraints are distributed on the phylogenetic tree like the morphological character states of adult animals and are associated with specific regions of the tree. From this perspective, we emphasize the importance of considering gene expression and embryonic anatomy as the mechanistic bases that can result in homologous or nonhomologous morphological patterns at later developmental stages. Taking the acquisition of the jaw and trabecula cranii as examples, we demonstrate that a set of embryonic features can be coupled or decoupled during evolution and development. When they are coupled, they exert an ancestral developmental constraint that results in homologous morphological patterns, and when they are decoupled, the ancestral constraints tend to be abandoned, generating a new body plan. The heterotopy behind the specification of the oral domain is an example of decoupling, based on shifted tissue interactions. We also stress the importance of "developmental burden" in determining the sequential order of changes through evolution.

Predicting caregiver burden from daily functional abilities of patients with mild dementia.

To assess the relationship between performance- and informant-based measures of activities of daily living (ADLs) in patients with early dementia and burden or psychological distress experienced by the patients' caregivers. Descriptive study. Ambulatory center. Thirty-four patient-caregiver dyads in which the patient had mild dementia (Mini-Mental State Examination score >17). A performance-based ADL measure (the Direct Assessment of Functional Status (DAFS)) was administered to patients with mild dementia. Caregivers completed an informant-based measure of patient functional status (instrumental activities of daily living). Caregivers also completed the Caregiver Burden Inventory (CBI) and the Brief Symptom Inventory (BSI). Significant correlations were found between the informant-based ADL measure and caregiver burden (CBI) and psychological distress (BSI) (correlation coefficient (r)=-0.34 to -0.71, all P<.05). Alternatively, fewer and weaker relationships were observed between the DAFS (performance-based) ADL measure and caregiver burden or distress ratings (r=-0.32 to -0.43, all P<.05). Of the seven tasks assessed using the DAFS, impairments in orientation, communication, financial, and transportation skills in patients were associated with greater time and developmental burden and greater hostility in caregivers. Impairment in financial skills in patients was the strongest predictor of time-dependence burden and hostility in caregivers, whereas impairment in patient transportation skills was the best predictor of developmental burden. The ADL abilities of cognitively impaired patients can predict caregiver burden and psychological distress, with informant-based measures having the greatest association with patient impairment.

The Effects of a Support Group Intervention on the Burden of Primary Family Caregivers of Stroke Patients

The purpose of this study was to develop and evaluate the effects of a support group intervention on the burden of primary family caregivers of stroke patients. A nonequivalent control group pretest-posttest design was used. The subjects were 36 primary family caregivers of stroke patients [experimental(N=18) and control(N=18) groups] in a neurosurgery ward of a university hospital. The experimental group members participated in six sessions of a support group intervention for two weeks and the degree of their caregiving burden was evaluated. Data was analyzed by Chi-square tests, t-tests, and paired t-tests using SPSS 10.0. The experimental group had a significantly lower total burden score (t=2.061, p= .047)and sub-scales of emotional(t=-3.319, p= .002), time-dependent(t=-2.045, p= .049) and developmental(t=-2.656, p= .012) burden scores than the control group, while no significant differences were found in physical, social or financial burden scores between the two groups. Within the experimental group, there was a significant decrease in physical(t=2.507, p= .023), emotional(t=4.754, p= .000), social(t=2.932, p= .009), time- dependent(t=5.015, p= .000) and developmental(t=7.541, p= .000) burden scores but not the financial burden score. The results suggest that a support group intervention can be utilized as an effective nursing program to reduce the burden of primary family caregivers of stroke patients.

Squeezing the Peasants: Grain Extraction, Food Consumption and Rural Living Standards in Mao's China

At the end of Mao's life farmers still accounted for some 80 per cent of China's population. Its declining share in GDP notwithstanding, agriculture continued to carry a heavy developmental burden throughout the Mao era. The production and distribution of grain – the wage good par excellence – held the key to fulfilling this role. But despite a pragmatic response to the exigencies of famine conditions in 1959–61, state investment priorities never adequately accommodated the economic, let alone the welfare needs of the farm sector. Thanks to the mechanism of grain re-sales to the countryside, the Chinese government's extractive policies were less brutal in their impact than those pursued by Stalin in the Soviet Union. Even so, a detailed national, regional and provincial analysis of grain output and procurement trends highlights the process of rural impoverishment which characterized China's social and economic development under Maoist planning.

High incidence of deformity in aquatic turtles in the John Heinz National Wildlife Refuge

The John Heinz National Wildlife Refuge is subject to pollution from multiple sources. We studied development of snapping turtle ( Chelydra serpentina) and painted turtle ( Chrysemys picta) embryos from the refuge from 2000 through 2003. Mean annual deformity rate of pooled painted turtle clutches over four years ranged from 45 to 71%, while that of snapping turtle clutches ranged from 13 to 19%. Lethal deformities were more common than minor or moderate deformities in embryos of both species. Adult painted turtles had a higher deformity rate than adult snapping turtles. Snapping turtles at JHNWR had high levels of PAH contamination in their fat. This suggests that PAHs are involved in the high level of deformities. Other contaminants may also play a role. Although the refuge offers many advantages to resident turtle populations, pollution appears to place a developmental burden on the life history of these turtles.

Evolution of shrub‐like growth forms in the lianoid subfamily Secamonoideae (Apocynaceae s.l.) of Madagascar: phylogeny, biomechanics, and development

Lianas are common in the Apocynaceae s.l. and are predominant in the subfamily Secamonoideae. Shrub-like taxa are rare within this subfamily but occur in Malagasy genera such as Secamone, Secamonopsis, and Pervillaea. We explored the evolutionary appearance of shrub-like growth forms in Malagasy Secamonoideae through a molecular phylogeny using chloroplastic sequences. The phylogeny revealed several independent appearances of shrub-like growth forms within the Secamonoideae. Biomechanics and development of the shrub-like growth form were detailed in one species, Secamone sparsiflora, which has upright and self-supporting young stems that become procumbent in older stages of development. Biomechanical investigations revealed characteristics atypical of both lianas and self-supporting shrubs. Anatomical development in S. sparsiflora is initially similar to lianas in the same clade but shows potentially neotenic retention of juvenile wood development for most of the growth trajectory. The results suggest that evolution of lianescence can carry a high degree of specialization and developmental burden that might limit evolution back to self-supporting growth forms. Under certain geographic and ecological conditions, such as geographic isolation, xeric conditions and/or reduced biotic competition, escapes from lianescence to other growth forms can occur in some angiosperm groups via relatively simple heterochronic shifts of mechanically significant growth processes.

Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses.

This study describes the health behaviors (alcohol consumption, exercise, sleep patterns, smoking, and weight maintenance) of a sample of older adult spouse caregivers (N = 233) and investigates the predictors of decreased self-care since caregiving began. Multiple regression results indicate that caregivers who experience greater developmental burden, report a greater number of depressive symptoms, perform a greater number of activities of daily living (ADL) tasks in caregiving and spend more hours in a day providing care, and who have lower self-efficacy for both self-care and spouse care are at greater risk for negative health behavior change. Results have implications for the identification of caregivers who may be particularly vulnerable to the negative health impact of caregiving.

The limits of economic globalization in East Asian developmental states

In an attempt to adjust to economic globalization or internationalization, East Asian developmental states have liberalized their domestic economic systems, accelerating the introduction of the free‐market ideology. Despite their plan to establish the internationally compatible open‐market economy, however, the extent to which they can advance economic liberalization is limited. Political and economic burdens that the developmental state's extensive intervention in the market has incurred in the course of state‐led mercantile economic development, make it impossible for those states to execute full‐scale economic liberalization. The South Korean case clearly shows this. The Korean developmental state retains two major economic burdens: the exclusive ownership and the poor financial structure of the chaebôl. Insofar as Korean big business preserves those weak spots, the government cannot surrender the power of regulation despite its spontaneous implementation of the economic liberalization policy. In addition, the common ‘egoistic’ interests which government bureaucrats and the political class share also limit the degree to which economic liberalization policy can be implemented. The degree of state intervention in the market in Korea has been deeper than that in Japan which pioneered Asian developmental statism, and, thus, the political and economic burdens it has incurred for itself are heavier. Consequently, the East Asian developmental state cannot entirely withdraw its intervention in the market. The ‘support’ of industries is likely to diminish, but ‘regulation’ for the formation of the autonomous market will increase. For the Korean developmental state, globalization and economic liberalization are political economic slogans to re‐launch economic growth and to elevate the international economic competitiveness of industries under the initiative of the state, and motivated by nationalistic reasons. Hence, the role of the state in the market is still far from becoming redundant even in the tide of globalization and economic liberalization in the case of South Korea, where the legacy of strong developmental statism remains considerable.