Women Family Caregivers Research Articles

Who Are Midlife Women Family Caregivers With Negative Attitudes Toward Alzheimer's Disease and Dementia Care?

Midlife women play a major role as the family caregivers of persons living with Alzheimer's disease (PLAD). Cultural differences are frequently the major reason for the high risk faced by racial and ethnic minority family caregivers. However, little is known about the characteristics of midlife women family caregivers that are linked to their negative attitudes toward Alzheimer's disease and dementia care. This study aimed to determine the characteristics of midlife women who were family caregivers of PLAD that were linked to their negative attitudes toward Alzheimer's disease and dementia caregiving. A secondary data analysis was conducted using data from 172 midlife women who were family caregivers of PLAD and participated in a large cross-sectional online survey. Linear multiple regression analyses were used for the data analysis. Participants' attitude toward Alzheimer's disease and related dementia scores were significantly associated with employment status, race/ethnicity (Hispanic), and instrumental activities of daily living. Those who were unemployed, Hispanic, and with low instrumental activities of daily living tended to have negative attitudes toward Alzheimer's disease and dementia care. Additional interventions should be developed to improve attitudes toward caring for persons with Alzheimer's disease and dementia in this specific group of midlife women who are family caregivers of PLAD.

It is Time to Address Fear of Cancer Recurrence in Family Caregivers: Feasibility and Acceptability of a Randomized Pilot Study of the Family Caregiver Version of the Fear of Recurrence Therapy (FC-FORT).

Fear of cancer recurrence (FCR) is common, persistent, and associated with lower quality of life, impaired functioning, and psychological distress in family caregivers (FC) of individuals with a cancer diagnosis. Interventions are needed to specifically target FCR in FC. This study aimed to pilot test the adapted Family Caregiver-Fear Of Recurrence Therapy (FC-FORT) to establish its feasibility, acceptability, and clinical significance. This pilot study used a mixed-method, parallel, two-group randomized control trial (FC-FORT vs. waitlist control group) design. Women FC were recruited through Canadian hospitals, community partners, and social media. FC in the intervention group completed 7 weekly sessions of virtual group therapy (FC-FORT) and an exit interview. All participants completed questionnaires at baseline, post-intervention, and 3-month follow-up. Feasibility (e.g., recruitment, allocation, fidelity), acceptability (e.g., dropout, completion, satisfaction) and clinical significance of secondary outcomes were evaluated. Descriptive statistics, mixed ANOVAs, and conventional content analyses were used. Regarding feasibility, 22 FC were recruited, 18 were randomized and therapist fidelity was 87%. As to acceptability, 67% of participants completed 5 sessions (33% dropout). Questionnaire completion rate was 92%. FC satisfaction was 80%. Analyses did not reveal any significant differences on the secondary outcomes between groups. Qualitative analyses revealed high importance, helpfulness, satisfaction, and group cohesion. Suggestions were made by FC for improvements. This is one of the first interventions to address FCR in FC. While acceptability of FC-FORT was good, important feasibility issues need to be addressed before moving forward with a larger randomized control trial. NCT, NCT05441384. Registered July 1st, 2022, https://classic. gov/ct2/show/NCT05441384.

It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver–Fear Of Recurrence Therapy (FC-FORT)

BackgroundFear of cancer recurrence (FCR) is common, persistent, and is associated with lower quality of life, impaired functioning, and psychological distress in cancer patients. Studies suggest that family caregivers of cancer patients experience equal or greater levels of FCR than patients themselves. In the past 5 years, several interventions have demonstrated their ability to reduce FCR among cancer patients and in patient-caregiver dyads. However, to date, no intervention exists to individually target family caregiver’s FCR. The aims of the proposed pilot study are to (1) assess the feasibility and acceptability of the newly adapted Family Caregiver–Fear Of Recurrence Therapy (FC-FORT) intervention to inform a larger randomized control trial study, and (2) estimate the clinical significance of FC-FORT. Initial evaluation of FC-FORT revealed high user satisfaction and usability.MethodsA parallel, two-group, pilot randomized controlled trial comparing FC-FORT to a waitlist control (care as usual) will be conducted. Participant inclusion criteria are (a) women family caregivers taking care of adult cancer patients (no recurrence), (b) experiencing clinical levels of FCR, (c) access to a computer/internet connection, and (d) living in Canada. Participants (n = 36) will be recruited at Ottawa and Toronto hospitals, previous study participant pools, through social media and community partners across Canada. Participants in the intervention group will complete the FC-FORT intervention (7 consecutive weeks of virtual group therapy and homework). Participants in the control group will be offered the intervention after their participation in the study. All participants will be asked to complete questionnaire packages at baseline (T0), immediately post-intervention (7 weeks; T1) and at 3-months post-intervention (T2). Feasibility (e.g., recruitment, allocation, fidelity), acceptability (e.g., dropout, completion, satisfaction) and clinical significance of secondary outcomes will be evaluated (i.e., FCR illness uncertainty). Participants in the intervention group will be asked to complete measures of group cohesion and therapeutic alliance and take part in a semi-structured exit interview exploring their overall experience with FC-FORT.DiscussionThis project will evaluate the acceptability and feasibility of the newly adapted FC-FORT to inform a larger trial.Trial registrationNCT, NCT05441384. Registered July 1st, 2022, https://classic.clinicaltrials.gov/ct2/show/NCT05441384

Family Caregivers' Attitudes and Perspectives About the Sexual and Reproductive Health of Women With Intellectual and Developmental Disabilities: An Online Survey.

Although sexual and reproductive health is critically important for women with intellectual and developmental disabilities (IDD), there is limited research elucidating the role of family caregivers in assisting women with IDD access sexual and reproductive health services and information. Understanding the family caregivers' attitudes and perspectives is essential to improving access to sexual and reproductive health services and information for women with IDD. A cross-sectional online survey of family caregivers of women with IDD was administered between June and October 2018. Quantitative analysis was conducted for closed-ended responses, and qualitative analysis was conducted for open-ended responses. The analytic sample included 132 family caregivers. Most participants were parents and reported being closely involved in their family member's access to sexual and reproductive health services and information. Although most participants expressed that sexual and reproductive health services and information are essential for women with IDD, qualitative analysis of participants' open-ended responses revealed both supportive and restrictive attitudes and perspectives on sexual and reproductive health services and information for women with IDD. Supportive attitudes and perspectives included (1) "knowledge is power;" (2) supported decision-making; and (3) protection against sexual abuse. Restrictive attitudes and perspectives included (1) dependent on the individual; (2) lack of autonomy; and (3) placing responsibility on disability. Greater attention from policymakers and practitioners to systems-level changes, including universal and accessible sexual education for women with IDD, supported decision-making, and sexual abuse prevention measures, are urgently needed.

RELATIONSHIPS AMONG ATTITUDES TOWARD DEMENTIA, QUALITY OF LIFE, AND MIDLIFE WOMEN’S SYMPTOMS IN FAMILY CAREGIVERS

Abstract Attitudes towards dementia and caregiving differ by family caregivers’ racial/ethnic backgrounds. However, there is a gap in the literature on midlife women family caregivers’ attitudes toward Alzheimer’s Disease (AD) and family caregiving. The study purposes were to (1) explore racial/ethnic variations in midlife women family caregivers’ attitudes toward AD and family caregiving and (2) examine the relationships among their attitudes towards dementia and caregiving, quality of life, and physical and psychological symptoms. This cross-sectional study was conducted through an online survey among 36 Whites, 41 African Americans, 40 Hispanics, and 55 Asians. The structured measures consisted of two types of attitudes (Attitude toward AD and Related Dementias Scale and Questions on Attitudes toward AD Caregiving), health-related quality of life (EQ-5D-5L), and multidimensional symptoms (Midlife Women’s Symptom Index). The data were analyzed using one-way ANOVA and multiple linear regression analyses with SPSS 26. Asian caregivers perceived the care recipients’ symptoms as more bothersome than White caregivers (p = .039). Asian caregivers reported lower levels of behavioral skills and shared responsibility compared with other racial/ethnic groups of caregivers (p < .01). African Americans showed more positive attitudes toward family caregiving compared with Hispanics and Asians (p = .001). The regression analyses indicated that more positive attitudes toward family caregiving were significantly related to a better quality of life and fewer symptoms (both physical and psychological symptoms; p < .05). Culturally tailored interventions that incorporate caregivers’ attitudes are needed to improve midlife women family caregivers’ quality of life and symptoms.

Caring for older men and women: whose caregivers are more distressed? A population-based retrospective cohort study

BackgroundTo our knowledge, no population-based studies have examined whether family or friend caregivers of men and women differ in their experience of distress over time. Thus, we aimed to describe, on a population-level and longitudinally, how older men and women care-receivers differed in their health and care needs, compare their caregivers’ distress trajectories, and identify factors that contribute to the observed differences.MethodsThis is a population-based, retrospective cohort study using routinely collected data. We examined longitudinally 485,407 community-dwelling Ontario residents, aged over 50 years, who have received at least one Residential Assessment Instrument-Home Care (RAI-HC) assessment between April 2008 and June 2015. Descriptive analyses were performed on the demographic characteristics, health profiles, and care needs of men and women. We also compared their caregivers’ baseline and one-year change in distress status. Logistic regressions were performed to examine if the effect of gender on caregiver distress is reduced after controlling for care-receiver’s health and functional status as well as their caregiver’s kinship and co-residence status.ResultsMen (39.5% of our cohort) were frailer, required more care, were mostly cared for by their spouses (52%), and mostly lived with their caregiver (66%). In contrast, women (60.5%) were more likely cared for by their child/child-in-law (60%), less likely to live with caregivers (47%), and received less care. Caregivers of men were more likely to be distressed at baseline (27.7% versus 20.4% of women caregivers) and remain distressed (74.6% versus 69.5%) or become distressed (19.3% versus 14.3%) throughout the year. In logistic regression modelling, the effect of care-receiver’s gender on caregiver distress is reduced from an unadjusted odds ratio of 1.49 (95% CI: 1.47–1.51) to 1.17 (95% CI: 1.15–1.19) when care-receiver’s health and caregiving factors are controlled for.ConclusionOlder men and women differed in health and care needs. Caregivers, especially those caring for men, were often distressed and remained so through time. These results highlight the need for policies that account for the differential care needs and caregiver profiles of men and women in order to offer targetted and appropriate support.

A Scoping Review of the Physical Health Needs of Family Caregivers of Older Women With Breast Cancer

This scoping review conducted mapping of relevant literature on the physical health needs of family caregivers of older women with breast cancer, gaps analysis, and suggests directions for future academic research. The PRISMA-ScR checklist by Tricco et al. (2018) guided the scoping review. Ten international databases were searched for academic articles published in English between January 2002 and January 2022. The 12,795 discovered articles were reduced to two sources of evidence. Extracted data were mapped out using a charting table. The analysis revealed a dearth of research on the subject of physical health of family caregivers of older women with breast cancer, a lack of detailed description of the physical health needs of family caregivers of older women with breast cancer, a lack of cultural, geographic, and ethnic diversity, a lack of studies on the physical needs/strains experienced by family caregivers aside from physical activity needs, underutilized research methodologies, gender differences that influence physical health needs of family caregivers, development of research tools, and lack of intervention/educational programs on physical health for family caregivers. Future research directions were suggested, and limitations were presented.

Informational and supportive needs of the family caregivers of women with breast cancer in a low resource context: A cross-sectional study

Introduction: The present study was conducted to assess the needs of family caregivers in 2020 during the COVID-19 pandemic. Participants and methods: Data were collected through purposive sampling from 103 participants and analysed by the Family Inventory of Needs (FIN) during the COVID-19 outbreak in 2020 (between July and September). Results: Informational and supportive needs were high for most caregivers (76%), but they were scored unmet by higher than 30% of the family caregivers in items 8, 9, and 16 of informative dimensions and items 15, 17, and 18 supportive dimensions. Also, the illness stage was significantly associated with the score of unmet needs (p = 0.03). Conclusions: Caregivers who live with women need more guidance and support. Considering the information and psycho-social needs of cancer caregivers may increase the satisfaction of health services and help improve the psychological well-being and quality of life of both patients and their caregivers.

Factors Associated with Screening Positive for Depression among Women Caregivers of Primary Palliative Care Patients in Kerala, India.

Background: The study encompasses findings from a prospective quantitative screening of women family caregivers for depression as part of a larger mixed methods study designed to develop and validate a caregiver burden inventory for the home-based palliative care programme in Kerala, India. Aim: We assessed the proportion of women caregivers screening positive for depression and explored the associated factors. Methods: The Primary care Screening Questionnaire for Depression (PSQ4D) was used to screen participants for depression. Other variables analysed were caregiver and patient related factors, stresses, strains, support received, caregiver burden and quality of life domain variables as per the EuroQol EQ-5D-5L instrument. Results: Forty women (20.0%, 95% Confidence Intervals [CI] 14.46% - 25.54%) screened positive for depression on the PSQ4D. This was more likely if the care recipient was the spouse, if the care recipient had cancer, if the caregiver perceived a moderate or high physical/psychological burden, or a high financial burden. Pain/ discomfort when included had an adjusted odds ratio (AOR) of 8.2 (95% CI 2.6-26.0) and tended to decrease the AOR of all other significantly associated variables, except cancer diagnosis in the care recipient. Conclusion: Depression levels among women caregivers in primary palliative care settings in Kerala seem comparable to prevalence levels among women in the general population. Those caregivers reporting pain/ discomfort should be screened for depression using simple locally validated measures. Depression is associated with higher caregiver burden and poorer quality of life. Screening and treatment of depression may help mitigate these situations.

Factors Associated With Engaging in Regular Physical Activity Among Women Family Caregivers

Regular physical activity is important for promoting the health of family caregivers. In this study, we used data from the 2015 and 2017 Behavioral Risk Factor Surveillance System Questionnaire-Caregiver module to examine factors associated with meeting physical activity guidelines among women caregivers. Meeting physical activity guidelines was defined as participating in 150 minutes (or vigorous equivalent minutes) of physical activity weekly. We used survey-weighted multivariate regression analyses to examine relationships between sociodemographic, caregiving, and health characteristics and meeting physical activity guidelines. All variables were entered into the model simultaneously. The Wald test was used to test the significance of interactions between race and ethnicity and other covariates. 50.7% of 10,542 women caregivers met physical activity guidelines. The amount of time spent caregiving each week was not associated with the odds of meeting guidelines. Caregivers in the paid workforce had decreased odds (OR=0.73, 95%CI [0.62-0.87]) of meeting guidelines. Compared to women caregiving for <6months, women caregiving for 6 months to 2 years had increased odds of meeting guidelines (OR =1.33, 95%CI [1.08-1.64]). Increasing education was associated with an increased odds of meeting guidelines, but being college educated had a more positive effect for Hispanic than white caregivers (pinteraction=0.03). Having children did not affect the odds of meeting guidelines for white caregivers, but for black caregivers having two or more children decreased the odds (pinteraction=0.03). Understanding how sociodemographic, caregiving, and health characteristics impact engagement in regular physical activity is critical to designing effective interventions and ultimately improving the health of caregivers.

Caregiver burden and associated factors amongst carers of women with advanced breast cancer attending a radiation oncology clinic in Nigeria

BackgroundThe responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria.AimTo assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer.SettingThe study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria.MethodsA cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained.ResultsOver half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78).ConclusionFamily caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.

Essential elements of caregiver support in gynecologic oncology.

160 Background: Caregivers are instrumental to the health and well-being of gynecologic cancer patients and can be deeply affected by the demands of caregiving. Our aims were to increase awareness of the unmet needs of family caregivers of women with gynecologic cancers and provide recommendations for essential elements of support needed by caregivers to ensure that family caregivers are recognized and supported as key members of the patients’ care teams. Methods: Over the course of a year, a 16-person steering committee and 40 stakeholders, including caregivers, patients, and clinicians, participated in a modified Delphi approach to assemble, review and prioritize a set of essential elements for caregiver support. The process culminated in a multi-disciplinary research roundtable. Stakeholders prioritized caregiver needs and discussed, brainstormed and prioritized essential support services necessary to meet those needs, using three rounds of consensus-building activities. Basic descriptive statistics were performed to feed means and rankings back to stakeholders prior to each round. Results: Stakeholders prioritized the top three needs of caregivers as: 1) to obtain information about their loved one’s cancer (M = 4.18, SD = 4.33), 2) how to provide support and comfort to their loved one (M = 3.18, SD = 3.92) and 3) how to maintain their own emotional health and well-being (M = 2.94, SD = 3.90). Fifteen Essential Elements of Support to address the needs of caregivers of women with gynecologic cancers were identified. These ranged from supports that are immediately actionable (e.g., information for the caregiver on managing the patient’s symptoms, skilled-care training, a point-person to help navigate the system) to more aspirational supports (e.g., integrative services focused on the health and well-being of the caregiver). Conclusions: Caregivers are an integral part of cancer care, though their needs are inconsistently addressed by the care team. In order to provide comprehensive quality care, clinicians and healthcare systems should strive to provide caregivers with the Essential Elements of Support identified in this study and continue to build a healthcare system incorporating caregivers’ needs.

Offspring Caregivers of Chinese Women with Breast Cancer: Their Social Support Requests and Provision on Social Media.

Background:Although a number of studies have examined social support needs among women with breast cancer, little attention has been paid to the burden and needs for social support among their family caregivers, who often report mental and physical problems associated with caregiving.Objective:This study aims to examine the role of social media in providing social support for offspring caregivers of breast cancer patients.Methods:A peer support group, "Having a breast cancer patient in my family," was created on Douban (www.douban.com), one of China's most popular social media sites, to provide social support to family caregivers of women with breast cancer. We analyzed the content of 784 messages in the discussion threads where the latest update fell between January 2017 and July 2017.Results:The results revealed that the majority of messages (n = 690, 88.0%) provided or requested social support, and more than 64.5% of these messages (n = 445) were posted by caregivers who were offspring of the cancer patients. The results also suggested that these caregivers requested and provided informational support more frequently than they did emotional and instrumental support.Conclusions:This study suggests that social media could be a plausible platform for offspring caregivers of breast cancer patients to share caregiving experiences, access informational resources for their care recipients, gain knowledge about breast cancer prevention, and obtain emotional encouragement. Theoretical as well as practical implications are discussed.

Experiencia de cuidadores familiares de mujeres con cáncer de mama: una revisión integradora

Objetivo: identificar la evidencia científica de enfermería relacionada con la experiencia de los cuidadores familiares de mujeres con cáncer de mama. Metodología: revisión integradora siguiendo los lineamientos de Ganong; búsqueda en bases de datos: EMBASE, OVID, PUBMED, SAGE journals, SCIELO, Google Academic, ISI Web of Science y SCOPUS, artículos publicados entre los años 2000 y 2016. Resultados: se incluyeron 18 artículos producto de investigaciones primarias de tipo cualitativo, cuyos referentes teórico-metodológicos fueron fenomenología y teoría fundamentada, las técnicas de recolección de datos fueron la entrevista semiestructurada y en profundidad. Se presentan y discuten como hallazgos las siguientes categorías: impacto del diagnóstico; lo que implica ser cuidador; efectos en el cuidador; estrategias de afrontamiento; cambios en los roles y las relaciones; apoyo social. Conclusiones: las características de los cuidadores son variables, es necesario conocer sobre la cultura y recursos propios de cada contexto. Los cuidadores requieren información clara y oportuna en relación su función y las habilidades a desarrollar, especialmente para otorgar apoyo emocional. Es necesaria la indagación de dichas experiencias en el contexto mexicano. Las relaciones padres e hijos en las familias de mujeres con cáncer de mama es un asunto poco estudiado, se requieren futuros estudios en este tema.

Need for micro-finance self-help groups among women family caregivers of persons with mental disability in rural India

PurposeMicro-finance self-help groups empower caregivers to indulge in productive activities based on the local availability of resources to reduce their financial burden. The purpose of this paper is to assess the need for and feasibility of initiating micro-finance groups for the caregivers of persons with mental disability in a rural socio-economically backward community of Karnataka, India.Design/methodology/approachThe design of the study was a cross-sectional survey, with mixed methodology design out of the eight localities where the Mental Health Public Health Centres (PHC) were running successfully in Konandur area, Thirthahalli Taluk, Karnataka, one PHC was selected using simple Random Sampling Design and a 5 kms radius from Konandur town was selected as the area of the survey (190 households). During door-to-door survey, if the family indicated that a particular member is mentally unwell, the GHQ-5 and Symptoms and Others checklist were administered on him/her and the women caregiver was interviewed using qualitative needs assessment schedule and Perceived Social Support Scale.FindingsTen persons/households with mental illness (5.26 per cent) were identified in the community. Themes of financial needs, capacity of the caregiver, community resources, need for the microfinance self-help groups, informational needs, social support, burn out, and stigma elicited in the interview were depicted in the form of a conceptual framework to understand the inter-connectedness between the various themes.Research limitations/implicationsThis study is the first initiative in the field of micro-finance self-help groups for the persons with mental illness and families. The design of the study was a cross-sectional survey, which is found globally to be the most suited in conducting prevalence studies, as it provides accurate results for future studies as well as it is the first step to obtain accurate baseline values to later plan a prospective follow up study. The study used mixed methodology design. Though the sample size was small, the information collected from the participants in qualitative and quantitative method was triangulated and conceptual frameworks were developed. As this study is one of the first of its kind in the country, the results of this study from the stated sample can be considered as an important pilot for future longitudinal and cross-sectional studies to be planned in the community.Originality/valueThere is hardly any scientific literature which talks about the need for Micro-finance self-help groups for Persons with Disability, especially with person with mental disability. In order to initiate any Micro-finance SHG activities, it is essential to first undertake the need for and feasibility of initiating such micro-finance group activities in any given area. This study will be an important milestone in initiating any self-help group activity for caregivers of persons with mental disability, as it would help us understand the financial needs of the community, based on which a draft proposal to initiate micro-finance self-help group activities can be drawn up.

Multidimensional Caregiving Burden of Female Family Caregivers in Korea.

The purpose of this study was to examine a staged theoretical model to explain cultural knowledge-based multidimensional burden of women family caregivers caring for community-dwelling older adults using a modified Poulshock and Deimling model. In the model, the antecedents included elders' impairment in activities of daily living (ADL), elders' cognitive impairment, caregivers' self-efficacy, and caregivers' familism. The perception contained the disruptive behavior burden and social functioning burden of caregivers. The consequence variable included social activity restriction and negative changes in family relationships. The total sample was 157 primary women caregivers caring for community-dwelling older adults aged 65 and older. Instruments were General Self-Efficacy Scale, Family Scale, and Burden Scale. Path analysis was done to analyze the model using multiple linear regression methods. This study showed that impairments of older adults (impairment in ADL, cognitive impairment) and caregiver beliefs (strong familism, low self-efficacy) had an indirect influence on negative changes in family relationship and social activity restriction through the perceived emotional distress.

Life experiences of caregivers of women with gynaecological cancer: a mixed-methods systematic review.

Family caregivers play a key role in meeting care needs of cancer patients. The aim of this review was to systematically examine life experiences of family caregivers of women with gynaecological cancer. A mixed-methods systematic review based on a retrospective review of the research on the topic was conducted. The review was limited to articles in English published between 1985 and 2014. The literature search was performed in CINAHL, Scopus, PubMed and ScienceDirect. A total of 16 full-text articles published in national and international journals were reviewed: 10 quantitative studies, 5 qualitative studies and 1 both qualitative and quantitative study. Of all caregivers with gynaecological cancer, 59% were partners, 27% were sons or daughters and 14% were brothers or sisters, mothers and friends. The qualitative research on caregivers' experiences revealed three themes: 'emotional devastation', 'change' and 'coping'. The family caregivers of women with gynaecological cancer had difficulty in areas examined, but the studies investigating caregivers' needs were limited to certain subjects and they were not solution-oriented. It is recommended that qualitative and quantitative studies including the solutions regarding family caregivers of women with gynaecological cancer should be integrated.

Religious Involvement and Telomere Length in Women Family Caregivers.

Telomere length (TL) is an indicator of cellular aging associated with longevity and psychosocial stress. We examine here the relationship between religious involvement and TL in 251 stressed female family caregivers recruited into a 2-site study. Religious involvement, perceived stress, caregiver burden, depressive symptoms, and social support were measured and correlated with TL in whole blood leukocytes. Results indicated a U-shaped relationship between religiosity and TL. Those scoring in the lowest 10% on religiosity tended to have the longest telomeres (5743 bp ± 367 vs. 5595 ± 383, p = 0.069). However, among the 90% of caregivers who were at least somewhat religious, religiosity was significantly and positively related to TL after controlling for covariates (B = 1.74, SE = 0.82, p = 0.034). Whereas nonreligious caregivers have relatively long telomeres, we found a positive relationship between religiosity and TL among those who are at least somewhat religious.

A review of "Family caregivers of women with breast cancer in Iran report high psychological impact six months after diagnosis".

The Foreign Exchange column launches a new approach to expanding the global understanding of oncology nursing challenges and concerns. Each issue will include a review of an article that appeared in the most recent issue of the European Journal of Oncology Nursing that is relevant to a shared, unique, or conflicting oncology issue or practice in the United States. This column reviews an article about the shared dilemma of distress caused by caregiver burden in the ever complex and shifting setting of care delivery.

Observing Women Caregivers’ Everyday Experiences: New Ways of Understanding and Intervening

This article discusses the practice implications of videographic research examining the everyday lived experiences of 5 women family caregivers of older adults with chronic illness. The women’s nonverbal expressions and gestures revealed how caregiving is accomplished and lived on a daily basis, in particular through emotion and body management, abnegation, and performance. The findings from this microethnographic study suggest that observing women caregivers’ everyday experiences can open new avenues for holistic intervention with this population. Observing nonverbal cues can offer a way for practitioners to better understand women caregivers’ realities, to question their practice, and to adapt their interventions accordingly.