Major Caregivers Research Articles

Exploring Similarities and Differences Between Shyness and Social Anxiety: An Analysis of Their Relations with Social Emotional and Language Outcomes in Hong Kong Kindergarteners

AbstractThis study investigates the similarities and differences between Hong Kong kindergarteners’ shyness and social anxiety and their possible relations with social emotional adjustment and the development of receptive language abilities. Data were collected from three kindergartens, with 71 children (mean age = 52.6 months, SD = 7.28; 48% boys) and their major caregivers participating at two time points, six months apart. Findings showed that children’s shyness and social anxiety levels were strongly correlated, and both were moderately correlated with children’s social emotional difficulties. Interestingly, children’s shyness uniquely predicted social emotional difficulties beyond social anxiety, but children’s social anxiety did not significantly predict their difficulties beyond shyness. Additionally, neither shyness nor social anxiety were found to be associated with children’s Cantonese receptive language skills. Our results highlight the strong similarities between shyness and social anxiety. Given the intricate interplay among the constructs examined in this study, more research is needed to further understand their relations and interactions. This knowledge may help educators to identify appropriate intervention targets to facilitate better language outcomes among shy and socially anxious kindergarteners.

Prevalence of and factors associated with demoralization among family caregivers of palliative care patients in Hong Kong.

This study aims to examine (1) the prevalence of demoralization among family caregivers of palliative care patients (PCP) in Hong Kong, (2) the percentage of caregivers who are demoralized but not depressed, (3) the factors associated with demoralization, and (4) the differences in caregivers' support needs between high and low levels of demoralization groups. Ninety-four family caregivers were recruited and completed a questionnaire that included measures of demoralization, depression and caregiving strain, caregivers' support needs, and demographic information. The prevalence of demoralization among family caregivers of PCP was found to be 12.8% (cutoff score = 50) and 51.1% (cutoff score = 30). Although 27.7% of caregivers met the criteria of depression and demoralization, 12.8% of demoralized caregivers were not depressed. Depression and caregiving strain were identified as the predictors of demoralization. Caregivers with a poorer subjective physical status and a lower education level are more prone to demoralization. The three major caregivers' needs for support reported were (1) knowing what to expect in the future (77.7%); (2) knowing who to contact (74.5%); and (3) understanding your relative's illness (73.4%). Those who experienced a high level of demoralization often reported more need for support in end-of-life caregiving. This is the first study that focused on the demoralization of family caregivers of PCP in the East Asian context. Demoralization is prevalent among these caregivers. We recommend that early assessment of demoralization among family caregivers of PCP be considered, especially for those who are more depressed and have a higher level of caregiving stress.

Psychometric Properties of the Child Neglect Scale and Risk Factors for Child Neglect in Chinese Young Males Who Were Incarcerated

Child neglect is an important risk factor for juvenile delinquency, while few studies have examined child neglect in Chinese juvenile delinquents due to the lack of appropriate measurement tools. The Child Neglect Scale is a 38-item retrospective self-report scale that specifically focuses on child neglect. The current study, therefore, aimed to examine the psychometric properties of the Child Neglect Scale and risk factors for child neglect among Chinese juvenile delinquents. A total of 212 young males who were incarcerated participated in this study, and the Childhood Trauma Questionnaire, Child Neglect Scale, and basic information questionnaire were used to collect data. The results showed that the Child Neglect Scale has good reliability, and the mean inter-item correlation coefficients reach accepted standards. Moreover, it is found that child neglect is prevalent among Chinese young males who are incarcerated, with communication neglect occurring most frequently. Low levels of family monthly income and rural residency are risk factors for child neglect. The average scores of security neglect, physical neglect, and communication neglect of the participants respectively show statistically significant differences according to the type of major caregivers. Findings suggest that the Child Neglect Scale may be used to measure child neglect with four independent subscales in Chinese young males who are incarcerated.

Cross-sectional assessment of medical students willingness to care toward older people in Taiwan

ABSTRACT The possibilities that medical students will take care of persons 65 years of age or older in hospitals and communities are increasing due to a growing aged population. This study marks one of the first in-depth attempts to explore willingness to care toward older peoples in Taiwan medical students. A cross-sectional research design was used. Stratified sampling was applied to recruit participants from six medicine colleges. There were 580 medical students who completed the questionnaire. A multiple regression analysis were conducted. The results found that the significant predictors of medical students’ willingness to care for older adults were perceptions of getting together with older people, grandparents were major caregivers during childhood, and experienced of being a volunteer who served older people. The findings of this study can provide information to faculty members and clinical preceptors for designing curricula and related activities or arranging practica.

A Glimpse on Gender Inequality in Paid and Unpaid Works During Pandemic Times

The paper aims to analyse the different challenges that the pandemic crises and lockdown measures have on women lives and works. Pandemic crises ask for carrying activities, both paid and unpaid, works that are usually done by women. The focus of the paper is on the impact of the apparently gender-neutral measures adopted by the Romanian government on the lives and careers of women. We find women as majority both in the frontline services, but also in the sectors that are most affected by lockdown measures. Also we find women as major caregivers in their families, as mothers or grandmothers. Starting with the challenges that we are all currently facing, the last part of the paper aims to portrait the gender roles after lockdown ends and economic crises will take the place.

QUALITY OF LIFE IN CAREGIVERS OF PEDIATRIC PATIENTS WITH CEREBRAL PALSY AND GASTROSTOMY TUBE FEEDING.

Cerebral palsy is the most common cause of physical disability in childhood. Caregivers of patients presenting tetraparesis cerebral palsy (TCP) and gastrostomy tube feeding (GTF) were selected for this study because both conditions represent a great demand for their caregivers. To describe the quality of life related to the state of health of caregivers of patients with TCP who were fed by gastrostomy, to assess the results linked to the mental health of these caregivers, to compare our data with data from other studies on children with cerebral palsy without gastrostomy and to evaluate the possible interference of gastrostomy in the quality of life. A number of 30 major caregivers were interviewed and assessed. Quality of life and mental health tools applied and analyzed only for caregivers were: Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36), WHOQOL-BREF and Beck scales. Other information (age, gender, marital status, number of residents per household and psychological support) was evaluated. The Spearman's rank correlation coefficient was used to analyze. A 5% significance level was adopted. Results obtained through questionnaires are as follows: moderate hopelessness in 20% of caregivers (the higher the number of residents per household the higher the level of caregiver's hopelessness); moderate and severe anxiety in 33.33% of the sample studied; moderate and severe depression identified in 46.67% of interviewed caregivers; health-related quality of life of caregivers of patients with TCP were found to be below world averages; no significant figures for suicide potential were noted for the population under this study. The HRQOL of caregivers of TCP patients who were fed by gastrostomy is below the average of the general population. Our results are very similar to those found in other studies that evaluated caregivers of patients with cerebral palsy with different degrees of neurological impairment and no report of using GTF, suggesting that the presence of gastrostomy did not negatively interfere with the caregiver's HRQOL.

Anticipatory grief and its influencing factors in major caregivers of patients with advanced cancer

Objective To explore the status of anticipatory grief in major caregivers of patients with advanced cancer and its influencing factors. Methods There were 329 major caregivers of patients with advanced cancer recruited between October 2017 and May 2018. The basic data questionnaire, Anticipatory Grief Scale and Perceived Social Support Scale were used in the investigation. Results The scores of anticipatory grief and perceived social support were 88.49±16.47 and 60.33±11.58 respectively. The result of multiple linear regression revealed that relationship with patients, perceived social support, gender and religion were associated with anticipatory grief and could explain 54.2% of the total variance. Conclusions Medical workers should provide assistance to the major caregivers of patients with advanced cancer, respect and encourage the appropriate participation of religious activities, encourage caregivers to fully express their feelings, decrease their adverse emotional reactions and improve their bereavement outcome. Key words: Advanced cancer patients; Major caregivers; Anticipatory grief; Influencing factors

The ultimate treat? Young Israeli children’s media use under their grandparents’ care

ABSTRACTA substantial effort was made over the years to reveal predictors of children’s screen time in an attempt to suggest effective ways to minimize its negative effects. Studies were mostly based on parents’ reports and ignored other major caregivers, particularly grandparents. Accordingly, this study offers a pioneer exploration of young children’s interactive and non-interactive media use under their grandparent’s care and the factors associated with extensive use. The study was based on an online survey of 356 grandparents of children aged 2–7, who reported taking care of their grandchildren at least once a week.The study shows that children spend about half of the time under their grandparents’ watch using various media. Use time increased with age and was higher among boys compared to girls. Non-interactive media use was explained by place and duration of care, number of parents’ instructions, bringing a mobile device to the grandparent’s home, having the television on in the background, and grandparents’ mediation efforts. Interactive media use was explained by duration of care and grandparent’s sex, with male grandparents contributing to longer use. These findings raise concerns regarding young children’s media use under their grandparents’ watch, but also suggest effective strategies for its reduction.

Correlation analysis of caregiver burden and quality of life in major caregivers of patients with type 2 diabetes

Objective To explore the effects of caregiver burden and quality of life in major caregivers of patients with type 2 diabetes and to discuss the correlation between the two, so as to provide a basis for intervening with quality of life in patients with type 2 diabetes and their major caregivers. Methods Totally 138 major caregivers of diabetes mellitus (DM) patients admitted in the Department of Endocrinology, Shangqiu First People's Hospital from March 2017 to August 2018 were selected by convenient sampling, and investigated with the general information questionnaire, the Family Burden Scale of Disease (FBS) and 36-item Short Form Health Survey (SF-36) . Results The caregiver burden score of the major caregivers of patients with type 2 diabetes was (14.56±7.96) ; the quality of life score was (67.57±19.83) ; and caregiver burden was negatively correlated with quality of life (r=-0.391, P<0.05) . Conclusions The overall caregiver burden in major caregivers of patients with type 2 diabetes remain at a medium level and their quality of life is low. The heavier the caregiver burden in major caregiver of patients with type 2 diabetes, the poorer their quality of life is. Targeted measures should be taken for family caregivers of DM patients to reduce their caregiver burden and improve their quality of life. Key words: Diabetes, type 2; Quality of life; Caregivers; Caregiver burden; Correlation

Effects of family empowerment program on positive feelings and emotions in major caregivers of patients with uveitis

Objective To explore the effects of family empowerment program on positive feelings and emotions in major caregivers of patients with uveitis. Methods The caregivers of the patients with uveitis who were admitted in the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2018 were selected using convenient sampling and randomly divided into the control group (n=63) and the observation group (n=67) by drawing. Patients and caregivers in the control group received conventional education by charge nurses, while patients and caregivers in the control group were treated with the family empowerment program on this basis. Positive Aspects of Caregiving (PAC) and Profile of Mood States-Simplified (POMS-SF) were used to evaluate the effects of intervention at 24 h after admission and 1 d before discharge. Results The PAC score of the observation group totaled (29.91±6.42) , and that of the control group was (25.69±5.28) after the intervention (t=4.079; P<0.01) . The dimensions of nervousness-anxiety, depression-frustration, anger-hostility and fatigue-dullness in POMS-SF of the observation group scored (1.88±0.45) , (1.90±0.44) , (1.80±0.43) and (2.09±0.39) , respectively, lower than those of the control group, energy-activity (3.43±0.57) points, higher than that of the control group (t=-3.087, -9.941, -11.636, -7.876, 15.479; P<0.01) . Conclusions The family empowerment program used for major caregivers of patients with uveitis can improve the positive feelings and emotions of the caregivers, whose effects are better than conventional ophthalmological nursing care. Key words: Uveitis; Family empowerment; Caregivers; Positive feelings; Emotions

Status quo and influencing factors of positive feelings in major caregivers of patients with temporomandibular joint ankyloses complicated with facial deformity

Objective To explore the level of positive feelings in major caregivers of patients with temporomandibular joint ankyloses (TMJK) complicated with facial deformity and to analyze their influencing factors. Methods Totally 101 major caregivers of patients with TMJK complicated with facial deformity who attended outpatient and inpatient service in the First Affiliated Hospital of Zhengzhou University from April 2014 to April 2017 were selected using convenient sampling. The caregivers' general information was collected, and the caregiver positive feelings scale was used to evaluate their positive feelings. Pearson correlation analysis was used to explore the correlation between positive feelings and general information, and multivariate linear regression analysis was employed to analyze their influencing factors. Results The caregivers' positive feeling scored (28.93±5.15) , ranging 10-39. Univariate analysis showed that there were statistically significant differences in positive feelings scores between caregivers with different sex, educational background, age, relationship with patients, monthly household income and cohabitation with patients (P<0.01) . Correlation analysis showed that the caregivers' positive feelings were correlated with sex, educational background, age, relationship with patients, monthly household income and cohabitation with patients (P<0.05) . Multiple linear regression analysis showed that sex, monthly household income, relationship with patients and cohabitation with patients were the influencing factors for the caregivers' positive feelings (P<0.01) . Conclusions The positive feelings in major caregivers of patients with TMJK complicated with facial deformity stand at a moderate and low level, which might be associated with the major caregivers' sex, monthly household income, relationship with patients and cohabitation with patients. Key words: Cross-sectional study; Caregivers; Temporomandibular joint ankyloses; Facial deformity; Oral and maxillofacial surgery; Positive feelings; Influencing factors

The experiences and feelings of major caregivers of children with nocturnal enuresis:a qualitative research

Objective To understand the experiences and feelings of major caregivers of children with nocturnal enuresis. Methods A semi-structured interview was conducted with major caregivers of children with nocturnal enuresis. Data were analyzed based on Colaizzi phenomenological research method. Results The major caregivers′experiences and feelings were classified into 4 themes, including overload care tasks, worry about the children with nocturnal enuresis, uncertain feeling of the prognosis, lack of family and medical support system. Conclusions Understanding the experiences and feelings of major caregivers of children with nocturnal enuresis can help medical workers realize their attending demands, provide professional services and promote the recovery of children. Key words: Nocturnal Enuresis; Children; Nursing; Qualitative Research

Effects of family involvement and WeChat extended nursing on postoperative rehabilitation in patients with cervical spinal cord injury

Objective To explore the effects of family involvement and online extended nursing for postoperative rehabilitation in patients with cervical spinal cord injury (CSCI) . Methods Totally 60 CSCI patients who were admitted and received surgery in Honghui Hospital, Xi'an Jiaotong University from October 2013 to July 2016 and their major caregivers after being discharged from hospital were equally divided into an observation group (n=30) and a control group (n=30) according to the random number table. Patients in the control group received conventional instructions 1 day before being discharged from hospital and telephone follow-ups in Week 1, Month 1, Month 3 and Month 6 after being discharged from hospital, while patients in the observation group received extended nursing via WeChat groups on this basis. The quality of life, incidence of complications and compliance of rehabilitation exercise six months after surgery were compared between the patients in the two groups. Results The patients in the two groups showed higher scores in various dimensions indicating the quality of life six months after surgery than they did at discharge, and the patients in the observation group showed higher scores than the patients in the control group (P 0.05) . The patients in the observation group showed higher compliance of rehabilitation exercise than the patients in the control group (P<0.05) . Conclusions Family involvement and WeChat extended nursing helps to build a long-term service system for CSCI patients and accelerate their postoperative rehabilitation, thus worthy of expansion and application. Key words: Rehabilitation nursing; Cervical spinal cord injury; Extended nursing; Family members; WeChat

A survey on requirements of major caregivers of elderly terminal stage patients

Objective To investigate the requirements of major caregivers of elderly terminal stage patients and to explore its influence factors. Methods A questionnaire survey was put into practice on 214 main caregivers of elderly hospice patients with ADL Katzs scale and questionnaires of self-established home care requirments. Results The total score of requirements of major caregivers of elderly terminal stage patients was( 94.86 + 10.03), the highest score was medical care needs(27.04±3.32), the lowest score was spiritual comfort demand(21.95±3.01). Gender, family care burden and self-perceived health status were the main factors which influence the requirements of major caregivers of elderly terminal stage patients(P<0.01). Conclusions The requirements of major caregivers of elderly terminal stage patients was in the upper level and are affected by multiple factors.Health care workers should conduct a comprehensive assessment and make personalized services to meet the requirements of major caregivers of elderly terminal stage patients, improving the quality of life of dying patients and their major caregivers. Key words: Elderly; End of life; Major caregiver; Care needs

Can family structure and social support reduce the impact of child victimization on health-related quality of life?

This study aims at providing a profile of the association between different types of child victimization and polyvictimization and health-related quality of life (HRQoL) among school-aged children, and examining the impact of family structure and social support on the negative health consequences associated with violent victimization. We conducted a cross-sectional school survey in Hong Kong using a two-stage stratified sampling procedure. The final sample comprised 4139 children’s self-reports and proxy-reports (boys=51.5%; mean age=6.3). The main outcome was HRQoL measured with the Pediatric Quality of Life Inventory (PedsQL). Family structure was represented by parents’ marital status, major caregivers, number of siblings and the living arrangement of children. Child victimization, social support, and demographic characteristics were also measured. All types of child victimization were associated with compromised HRQoL, and the strength of association varied across different types of child victimization. Family structure (in particular the number of siblings and whether additional childcare was received from grandparents) and social support were associated with better HRQoL. The negative associations between child victimization and polyvictimization and HRQoL were reduced when there was an adjustment made for family structure and social support. Findings show that family structure and social support are related to a reduction in negative health consequences for child victimization. The varying strengths of negative associations between victimization and HRQoL highlight the possibility that the effects of child victimization on health might not be homogeneous.

Intergenerational transfers and informal care for disabled elderly persons in China: evidence from CHARLS.

Aiming at 'ageing healthier and ageing better', a certain amount of high-quality informal care should be available for elderly persons with physical disability as formal care is barely accessible in China. The demographic transition and family structural changes have dramatically weakened traditional norms of filial piety and the structure of intergenerational transfers. This article employed nationwide representative data from the first wave (2011) of Chinese Health and Retirement Longitudinal Study (CHARLS) in order to identify the duration of informal care provision at home for frail elders (1122 in rural areas and 577 in urban areas, total 1699), measured in monthly hours, before estimating the associations between intergenerational transfers and the received time of informal care with Tobit Model analysis. Results showed that financial support from the younger generation was unexpectedly negatively associated with the monthly hours of care, implying a reduction of caring support along with increasing financial transfers towards older parents. The lack of informal care could not be compensated by having more children, co-residing with children, or increasing the parent-to-child/grandchild transfers. Spouses were shown to replace children as the major caregivers. In addition, the community-based long-term care system needs to be promoted to sustain and develop informal care, as the latter will become increasingly important with changing family dynamics. Finally, the received time of informal care, rather than the severity of physical disability measured by difficulty with ADLs or IADLs, was introduced to identify the actual demand for care by elders. The paper argues that it is important to reconceptualise and re-investigate the duration of care provision in the Chinese context in order to develop standards of payment as part of long-term care policies.

Influencing factors on the resilience of major caregivers for disabled elderly

Objective To explore the influencing factors of disabled elderly caregivers’ resilience, and to provide evidence for further intervention studies. Method Totally 221 caregivers in several communities were investigated with self-design general questionnaire, Activity of Daily Living Scale(ADL), Conner-Davidson Resilience Scale(CD-RISC) Chinese version, Simplified Coping Style Questionnaire(SCSQ), General Self-Efficacy Scale(GSES) and Perceived Social Support Scale (PSSS). Results The caregivers’ resilience score was 59.99±15.86, at a medium level and lower compared with normal population(t=-5.07, P<0.01). It was positively correlated with the positive coping(r=0.468, P<0.01), general self-efficacy(r=0.546, P<0.01)and perceived (r=0.372, P<0.01). Multiple stepwise regression analysis showed the positive coping, self-efficacy and social support of caregivers were influencing factors of caregivers’ resilience(P<0.01). Conclusion Disabled elderly caregivers’ resilience is lower than the general population, and implementation of the intervention should be taken according to different resilience levels at clinical practice. Key words: Disabled elderly; Caregiver; Resilience; Influencing factor

On My Own: A Qualitative Phenomenological Study of Mothers of Young Children with Autism Spectrum Disorder in Taiwan

There has been a dramatic increase in autism around the world. However, little is known about the impact of the Taiwanese primogeniture system on mothers of children with ASD. Greater knowledge is needed to understand the life experiences of Taiwanese mothers with ASD children when a healthy male descendent is expected. Research follows the hermeneutic phenomenological approach with in-depth interviews and participant observation (Agar, Speaking of Ethnography. Sage, California, 1986). The researchers collected and analysed stories from seven mothers who are the major caregivers of their school-aged autistic children. The data revealed the following themes that represented the mothers' experiences: taking the blame, my world was turned upside down, a child-centred life and two lives as one. The findings provide a deeper understanding of common expectations of, and behaviours directed towards, Taiwanese mothers of children with autism. This offers healthcare professionals ways of reconceptualizing therapeutic practice, thus benefitting these mothers.

Memory and behavior-related problems of patients with neurocognitive disorders and the attitudes of their caregivers

<h3>Objective</h3> The purpose of this study was to investigate the memory and behavior-related problems of patients with neurocognitive disorders and the attitudes of their caregivers so as to provide an effective basis for nursing interventions against such problems. <h3>Methods</h3> The subjects were selected from patients who were under treatment or short-term hospitalization between April 2011 and March 2012. One hundred fifty-three patients with neurocognitive disorders and their major caregivers were selected from 9 Grade 3 Class A hospitals of Hunan Province. The Revised Memory and Behavior Problems Checklist (RMBPC) was used to measure the memory and behavior-related problems of patients with neurocognitive disorders and the influence on their caregivers. The occurrence of different memory and behavior-related problems and the distress on their caregivers was compared. <h3>Results</h3> The RMBPC investigation showed that among 153 patients and their caregivers, 152 (99.3%) had memory-related problems, 137 (89.5%) had depression, and 136 patients (88.9%) had destructive behaviors. The incidence of memory-related problems was higher than depression and destructive behaviors (<i>P</i>&lt;0.01). Caregivers bore more distress when encountering destructive behaviors (1.95±1.13 points) than memory-related problems and depression (0.91±0.76 points and 0.89±0.85 points; <i>P</i>&lt;0.01). Curve fitting was used to analyze the relationship between the number of memory and behavior-related problems and the distress on their caregivers. A curve correlation existed between the two factors (the recorded maximum value of the Cubic equation curve was 0.278, F=229.212, <i>P</i>&lt;0.05). <h3>Conclusion</h3> Among patients with neurocognitive disorders, memory-related problems had the highest incidence, while the caregivers bore the strongest distress when encountering destructive behaviors, thus interventions should be conducted in consideration of patient memory and behavior-related problems, and caregivers’ attitude to further reduce caregiver burden.

Violence and Mood Disorder: Views and Experiences of Adult Patients With Mood Disorders Using Violence Toward Their Parents

The study explored the lived experiences of violence by patients with mood disorders against their biological parents who were the major caregivers (13 parent-adult-child dyads), and sought to gain an understanding of the precipitating factors influencing violence. Data were collected by means of in-depth semi-structured interviews, managed and subjected to hermeneutics-guided thematic networks analysis. The phenomenon was that violence was part of life. The four global themes were that increased irritability and poor impulse control lead to violence; violence causes anxiety; a transition from violence to nonviolence is difficult; and moving from descriptions of violence to analyses of violence is important. A comprehensive dyadic parent-child intervention program and de-escalation techniques are suggested to manage violence substantially.