Abstract Background Significance: Cancer stigma in India continues to be a major barrier for both patients and their families, largely driven by inadequate awareness, limited health literacy, and persistent cultural misconceptions. Such stigma leads to fear, delayed health-seeking, reduced adherence to treatment, and emotional distress. It also places substantial social, psychological, and economic burdens on caregivers, who may experience isolation, discrimination, and heightened anxiety. Understanding stigma levels among healthy individuals is essential, as they represent the future caregivers and potential patients who will shape community attitudes. This study aims to assess the level and pattern of cancer-related stigma among the healthy population in Western Maharashtra. Materials and Methods: A cross-sectional study was conducted among 267 healthy individuals visiting a tertiary care hospital in Western Maharashtra, India, from March 2023 to August 2023. Participants aged 18 years and above who had no prior diagnosis of cancer were included using a convenient sampling method. Data were collected through a structured, self-administered questionnaire incorporating the validated Cancer Stigma Scale (CASS), which assesses six subdomains: Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility, and Financial Discrimination. Each item was scored on a Likert scale, and subdomain scores were calculated accordingly. The questionnaire also included sociodemographic details such as age, gender, education, occupation, and socioeconomic status. Data entry was performed in Microsoft Excel and analysis was carried out using SPSS version 26. Descriptive statistics including median, mean, and standard deviation were computed. Inferential analysis using the Mann–Whitney U test was performed to assess associations between stigma levels and demographic variables, with statistical significance set at P < 0.05. Results: Levels of cancer stigma were moderate but varied across the six subdomains in our study. The attitudes of respondents were reflected through their agreement with various statements, where 35% of people agreed on “Cancer patient being liable and accountable for their condition,” approximately15% believed that “Once you’ve had cancer you’re never normal again,” while 9% of respondents felt that “Cancer devastates the life of those it touches.” Furthermore, 45% of healthy individuals expressed that “It is not acceptable to refuse the bank loan for the cancer patient.” About 43% people strongly agree on “policy opposition,” i.e. “More government funding should be spent on care and treatment of those with cancer.” People strongly disagree on any kind of awkwardness or avoidance related to cancer patients. Significant differences in policy opposition are observed among participants with distinct employment status ( P < 0.05). Conclusions: The study indicates the enduring presence of cancer stigma among the healthy population in Western Maharashtra, with the observed highest stigma related to the severity of the disease and policy opposition. Findings provide a critical baseline for designing targeted educational and stigma-reduction interventions, particularly for communities expected to serve as caregivers in the future.

Professional stance development in nursing students: An analysis of patient-student interactions through self-confrontation.

Empowering future caregivers: the role of self-leadership in reducing stress among nursing students

Empowering future caregivers: the role of self-leadership in reducing stress among nursing students

Typically developing siblings' acceptance of a sibling with Down syndrome (DS) or autism influences the nature of sibling relations and their willingness to care for their sibling with disability in the future. Optimism is a central personality characteristic in coping with challenging life situations and the emotions toward the sibling with Down syndrome/autism are prominent in siblings' adjustment to their complex circumstances. The current study examined how optimism and emotions toward a sibling with Down syndrome or autism influence typically developing siblings' acceptance of their sibling with a disability. The role of demographic variables (sex of the typically developing sibling, diagnosis, and independent functioning of the sibling with disability) was also considered. Participants included 520 Jewish-Israeli siblings (189 brothers, 331 sisters, aged 18-27). Of these, 284 had siblings with Down syndrome, and 236 had siblings with autism. Siblings completed self-report questionnaires on optimism, emotions, and acceptance. Hierarchical regressions with three-way interactions revealed that optimism, sex, and the sibling's diagnosis and independent functioning explained a significant portion of variance in acceptance. The findings highlight the importance of fostering optimism and emotional processing, particularly for siblings of individuals with autism and among brothers. These results have implications for interventions aimed at improving sibling relationships and future caregiving.Lay AbstractBeing a brother or sister to an individual with Down syndrome or autism can shape how siblings feel about and care for their sibling with the disability. This study looked at how optimism (a general positive outlook) and emotions relate to accepting the individual with the disability. The study also considered whether the non-disabled sibling's gender, diagnosis (Down syndrome or autism), and level of independent capability of the sibling with the disability contributed to the acceptance levels. Participants in the study were 520 Jewish-Israeli young adults (ages 18-27) who had a sibling with Down syndrome or autism. They answered questions about their emotions, optimism, and acceptance of the sibling with the disability. The results showed that optimism and emotions were important for acceptance, but this varied depending on whether the typically developing sibling was male or female, whether the sibling had Down syndrome or autism, and their level of independent capability. These findings suggest that helping siblings, especially brothers of individuals with autism, build optimism and process their emotions, can improve sibling relationships and support future caregiving roles.

This study utilized the BIG KINDS news analysis system to extract and analyze 305 domestic media reports published through November 15, 2025, using the keyword “oreign caregivers” As a result, first, in terms of annual reporting trends, the concentration of reports on foreign nursing assistants increased after the Ministry of Justice and the Ministry of Health and Welfare announced the designation of ‘Foreign Caregiver Training University’ in August 2025. Second, word cloud analysis showed that “Ministry of Health and Welfare,” “Ministry of Justice,” and “manpower shortage problem” were key words, confirming that the introduction of foreign caregivers is a multidimensional issue that combines welfare and immigration policies. Third, the relationship analysis revealed that ‘international students’ emerged as the most central keyword, demonstrating that visa conversion and human resource development methods based on international students constitute the core structure of media discourse. This study is significant in that it empirically presents the trends and key issues in media coverage related to the foreign caregiver system, thereby providing fundamental data for developing future caregiver supply and demand policies and strategies for utilizing foreign workers.

Record numbers of Americans are living with serious illness and disability. Increasingly, older adults and persons with disability will be responsible for managing and financing their care needs into older age, putting more onus on individuals and their families to arrange care. Understanding the current and expected caregiving landscape can inform efforts to prepare for future population needs. We used nationally representative survey data collected in Spring 2025 (N = 2020) to estimate the prevalence of past, current, and expected future caregiving and examine the association of sociodemographic characteristics and caregiving responsibilities using logistic regression. We found that one in four U.S. adults reported caregiving within the last year, and most (60%) expected future caregiving responsibilities, corresponding to over 155 million adults. After adjusting for socioeconomic characteristics, the strongest positive predictors of expected caregiving were prior or current caregiving experiences. We found no significant difference in anticipated future caregiving across political ideology. Our findings collectively underscore the universality of caregiving, and, within the context of scarce long-term care insurance uptake and declining funding for Medicaid, amplify the importance of scaling policies that support current and future family caregivers who provide the bulk of long-term care in the United States.

ABSTRACT This study aims to identify the factors influencing the artificial intelligence (AI) anxiety levels of long-term care students, who are expected to become formal caregivers in the future. To achieve this objective, interviews were conducted with 112 students enrolled in the Older care program at Düzce University Vocational School of Health Sciences. Data were collected using a personal information form, which included sociodemographic variables, and the AI Anxiety Scale. The findings indicate that participants’ levels of AI anxiety may be influenced by factors such as gender, income level, familiarity with AI in daily life, and trust in AI applications within the field of long-term care. Based on these results, the study suggests that reducing inequalities and addressing AI-related concerns among students in long-term care, gerontology, and geriatrics, as well as among care recipients and caregivers, is crucial for the effective integration of AI-based gerontechnology. The study further recommends discussing age-friendly AI solutions to facilitate the adoption of gerontechnology by future caregivers.

Abstract In 2021-22, approximately 37.1 million Americans provided care to family or friends (U.S. Bureau of Labor, 2024). Caregiver strain may differ across age, gender, race (Young et al., 2019). Given the effects of Social Determinants of Health, such as financial stability, health care, and food resources (Duran & Perez-Stable, 2019), some adults may experience additional threats to health and quality of life before entering the caregiver role. Little is known about those who anticipate becoming a caregiver. Knowing key information about anticipated caregivers would allow better programs and policies for future caregivers. The current study includes 97,914 participants (Mean age = 55.56, 45.8% female, 81.6% white non-Hispanic) who completed the 2022 BRFSS. Approximately 20.1% were current caregivers, 10.47% anticipated becoming a caregiver in the next two years, 5.3% were unsure, and 64.11% did not anticipate becoming a caregiver. A multinomial logistic regression examined the contributions of key demographic characteristics and economic social determinants of health (eSDOH) to predicting group membership, χ²(60675) = 1832.60, p < .001. Compared to current caregivers, anticipated caregivers were more likely to be: younger (OR = .99), male (OR = 1.2), and unemployed (OR = .81). Challenges related to eSDOH were higher for current than for anticipated (OR = .89), unsure (OR = .76), and those not anticipating becoming a caregiver (OR = .73). Additional post hoc analyses compared anticipated caregivers to unsure and not anticipating. More resources should be available for those prior to becoming a caregiver to alleviate future caregiver strain.

As the prevalence of dementia is predicted to increase three-fold in the coming decades, there is critical need for effective interventions to support caregivers who play essential role in the health and wellbeing of individuals with dementia. Current evidence-based caregiver interventions, such as Resources for Enhancing All Caregivers Health (REACH-VA), focus on cognitive and behavioral strategies to lessen caregiver burden. The Practice of Acceptance, Awareness, and Compassion in Caregiving (PAACC) combines mindfulness and practical caregiving skills to reduce caregiver strain and enhance caregiver's resilience. The goal of this intervention is to help caregivers develop increased present-focused acceptance and awareness of their reactivity to care-related stressors, while fostering empathy towards their loved one with dementia. This approach differs from strategies that challenge or replace negative or unrealistic stress-related thoughts, considering the often progressive and unchangeable nature of stressors in dementia. This study compared the effectiveness of a mindfulness based PAACC intervention to cognitive behavioral based REACH-VA intervention. This study enrolled 133 dementia caregivers with moderate to severe levels of caregiver burden who were randomized to either cognitive behavior based (REACH-VA) or mindfulness based (PAACC) support intervention. Study assessed caregivers for stress levels, perceived stress, rumination as well as mindfulness using validated questionnaires. The mean age of caregivers was 67yrs, predominantly white and most lived with their loved one that they were caring for. Both interventions reduced perceived stress, caregiver burden, and rumination. Caregivers who received PAACC showed lower anxiety (B=-2.76, p<0.001) and depressive symptoms (B=-2.50, p<0.01). PAACC participants exhibited higher levels of mindfulness after the intervention, with a significant increase indicated by a coefficient of 6.04. The study shows that while both interventions are beneficial, PAACC offers an additional advantage in enhancing psychological well-being of the caregivers. The increase in mindfulness suggests that PAACC caregivers were able to internalize practices taught in the intervention leading to better coping strategies. The results highlight the potential benefits of integrating mindfulness into future caregiver interventions.

Abstract Multiple informal caregivers are often involved in dementia caregiving, yet little is known about how families collectively respond to care-related changes over time. Guided by family stress theories, this longitudinal study aimed to 1) examine changes in care demands and use of resources, and 2) identify predictors of adaptive family responses. Participants were 90 informal caregivers (22% spouses; mean age = 55.8 ± 12.4 years) of community-dwelling PLwD in Hong Kong. Data were collected via telephone interviews in 2021 and 2025, and analyzed using repeated measures and multiple regression. Over four years, PLwD showed significant declines in ADL, IADL, and health-related quality of life (QoL) (all p&amp;lt;.001). While the number of informal caregivers remained stable, there were increases in the use of foreign domestic helpers (38% to 52%), formal care services (39% to 62%), and informal care time (512 to 729 hours/month). Caregivers reported increased care burden (p&amp;lt;.001) and reduced health-related QoL (p=.005). After adjusting for functional decline, predictors of involving more informal caregivers were fewer members participating in care-related decision making (B=-0.716, p&amp;lt;.001) and higher care burden (B = 0.043, p=.007). Predictors of increased or sustained use of social services included fewer decision-making caregivers (OR = 0.341, p=.036), better relationship quality with PLwD (OR = 2.13, p=.048), and higher expectations for future caregiving needs (OR = 1.16, p=.028). Our findings suggest that families with enmeshed dynamics and misaligned care expectations may be at higher risk for maladaptive functioning, highlighting the need for early identification and targeted support programs in shaping adaptive responses to dementia care over time.

Abstract Many older adults require assistance with activities of daily living as they age. Assistance can be provided as long-term care services in the home, an assisted living facility, or a nursing home. This study aimed to understand US adults’ perceptions of and planning for future long-term care needs, using a nationally representative survey of U.S. community-dwelling adults aged 50 and older (N = 3,486). Respondents were asked about their perceived future need for long-term care services, knowledge about long-term care payors, and engagement in long-term care planning. Survey findings indicated that 42.6% reported they were likely to require long-term care in the future. However, over half were not confident that they would be able to afford to pay for long-term care services (50.9% home care, 57.7% assisted living, 62.3% nursing home care). Additionally, 61.6% incorrectly thought Medicare would cover the cost of their long-term care in a nursing home. Another 29.4% indicated Medicaid would pay for it, and nearly half (49.6%) indicated they would pay for it from their own financial resources. Half (50.1%) of respondents indicated they had not undertaken the usual steps for long-term care planning; only 27.2% reported having appointed a durable power of attorney for healthcare, and 23.7% had identified potential future caregivers. Most adults indicated they could not afford long-term care services if needed, and half of them have not taken steps to plan for such care. Educating and supporting aging US adults in planning is necessary to prepare for their future long-term care needs.

Background: Due to the dwindling number of acute care facilities, and the rising number of patients requiring care, the healthcare arena is changing. Patients require care in the outpatient arena. Nursing academia needs to retool future caregivers to provide prelicensure outpatient clinical sites to resemble the changing healthcare landscape. Results: Eight prelicensure nursing students (n = 8) were selected to have the majority of their clinical in the community. Clinical formats differed per course based on availability of clinical partner settings. This program was successful in graduating 7/8 students in the first cohort. Overall satisfaction was achieved in the first cohort leading to program continuation and increased student interest.&amp;nbsp; Conclusions: Although successful, challenges in operating this program remain relative to the clinical format, availability of clinical placements and student satisfaction.

It is expected that blinatumomab will be increasingly incorporated into the care of children with B-lineage acute lymphoblastic leukemia (B-ALL) based on improved survival for subsets of patients and a favorable safety profile. Most of the 28-day continuous infusion can be administered in outpatient or home settings. Limited studies have described low rates of complications at home when appropriate safety plans are in place. However, home administration shifts the burden of monitoring and care to caregivers. Caregivers of children with B-ALL within 1month of completing a first cycle of blinatumomab at home were recruited from three tertiary care centers and participated in virtual, audio-recorded, semi-structured interviews, with translation services available as required. Interviews were transcribed, coded independently in duplicate, and analyzed using thematic analysis. Identified caregiving context-specific barriers and facilitators were coded deductively. Participating caregivers (n = 21) described a time-bound confidence response where initial infusion anxiety was gradually replaced with caregiving self-assurance. Growing confidence co-occurred with improved caregiver wellness and child quality of life, characterized by resuming more usual family activities amid therapy. Barriers and facilitators to successful home-based blinatumomab included caregiver knowledge and skills, access to hospital-based support, and particular aspects of a family's social and material environment, and these underpinned recommendations for future caregivers. Caregivers can confidently manage home-based continuous infusion blinatumomab with anticipatory guidance and support, and with attention paid to context-related modifiers to care. Caregiver insights should be reflected in the principles that become the basis of future pediatric B-cell ALL clinical trials and care.

Background: The literature is replete with data suggesting that Black, Indigenous, and People of Color (BIPOC) and first-generation college (FGC) students need more support during their transition to college. Methods: This descriptive, cross-sectional pilot study examined students’ satisfaction andprogram outcomes after skills and team building events in the Connecting Future Caregivers Program (CFCP). This study occurred at a research-intensive university in the mid-Atlantic region. Data were collected using post-event, anonymous evaluation surveys that included Likert-type questions and open-ended questions. Results: After a skills building simulation event, students realized that healthcare providers must listen, ask clarification questions (M = 5.00[0.58]), and be aware of body language (M = 5.29[0.76]). Within one month, some students felt overwhelmed with coursework (M = 4.29[1.11]), yet most planned on using their newly learned skills (M = 5.57[0.49]). Conclusion: Programs like the CFCP demonstrated that a more deliberate and proactive approach cultivates a supportive community for BIPOC and FGC students.

Factors influencing patient safety competence among Chinese vocational nursing students: A mixed-methods study using COM-B model and theoretical domains framework.

The health and social needs of LGBT older adults remain underrepresented in public health research, particularly in states where data collection on sexual and gender minorities has been limited. This study reports findings from the Kentucky LGBT Health Needs Assessment, a community-generated, statewide evaluation of adults aged 50 and older. Employing a cross-sectional, mixed methods design, the survey was developed in collaboration with LGBT community stakeholders. The assessment captured a broad range of demographic, health, psychosocial, and service access variables, with 672 individuals completing the study. Findings reveal a predominantly white, highly educated sample with a mean age of 59.5 years. Participants reported relatively positive perceptions of their general health, yet high rates of chronic conditions such as arthritis, hypertension, and obesity. While most found healthcare information accessible, 21% had unmet medical needs and 18% delayed care due to lack of affirming providers. Mental health and counseling services were especially difficult to access, particularly among rural respondents. Long-term care concerns were prominent, with strong preferences for LGBT-specific facilities and uncertainty about future caregiving arrangements and financing. Although participants largely expressed pride and comfort in their LGBT identity, experiences of discrimination, verbal abuse, and stereotyping were common. Despite high identity affirmation, community engagement was limited, often reflecting safety concerns and structural stigma. This needs assessment provides one of the first statewide snapshots of LGBT aging in Kentucky, highlighting both strengths and vulnerabilities in health and social well-being. Findings underscore the urgent need for inclusive policies, provider training, and tailored aging services.

This study explores the lived experiences of neurotypical siblings who have a brother or sister on the autism spectrum. Drawing on qualitative case studies of three adolescent siblings, the research investigates the emotional, social, and developmental impacts of these relationships. Through semi-structured interviews, the study identifies themes such as caregiving responsibilities, the emotional burden of unequal attention, and future caregiving concerns. The findings highlight both the challenges and growth opportunities associated with these sibling relationships. By examining these experiences within the unique cultural context of Malta, this study contributes to the broader discourse on inclusion and family dynamics in autism spectrum disorder (ASD). Implications for educational systems, family support programmes, and future policy developments are discussed.

ABSTRACT With the global population aging, it is imperative to have a thorough understanding of the unmet needs experienced by older adults who require caregiving or are informal caregivers. It is also important to understand how the perspectives of caregivers and care recipients might differ and interact to mutually shape experiences during the care journey. The primary aim of this study was to provide an in-depth and holistic understanding of the unmet needs and challenges experienced by older informal caregivers and care recipients. In-depth interviews were conducted in Singapore with 43 participants aged 60 years and above (35 caregivers and eight care recipients). Five main themes emerged from the analysis of the data: i) unmet needs due to informational gaps, ii) fear of burdening family members, iii) caregivers’ de-prioritization of self-care due to care recipients’ needs, iv) differing views between caregivers and care recipients, and v) concerns about the future. These findings highlight challenges that are especially pertinent to older informal caregivers and care recipients and suggest the need to improve support for them, including having more frequent check-ins, recalibrating policies and programs for more flexible and person-centered support, and facilitating more conversations between care recipients and caregivers about future caregiving arrangements. (198 words)

This study explores the lived experiences of neurotypical siblings who have a brother or sister on the autism spectrum. Drawing on qualitative case studies of three adolescent siblings, the research investigates the emotional, social, and developmental impacts of these relationships. Through semi-structured interviews, the study identifies themes such as caregiving responsibilities, the emotional burden of unequal attention, and future caregiving concerns. The findings highlight both the challenges and growth opportunities associated with these sibling relationships. By examining these experiences within the unique cultural context of Malta, this study contributes to the broader discourse on inclusion and family dynamics in autism spectrum disorder (ASD). Implications for educational systems, family support programmes, and future policy developments are discussed.