Caregivers Of Outpatients Research Articles

Evaluation of Family Caregiver Burden among COVID-19 Patients

Background:Coronaviruses are a large group of viruses from the Coronaviridae family. Not only do the coronaviruses disrupt patients' lives, but they also affect caregivers. This study aimed to assess the burden of family caregivers of COVID-19 patients discharged from a hospital in eastern Iran.Materials and Methods:A descriptive cross-sectional study was conducted with 210 family caregivers of COVID-19 inpatients and outpatients. A total of 210 COVID-19 patients referred to 22nd-Bahman Hospital of Khaf from March 2020 to June 2020 were selected via simple randomization. Data were collected using the Zarit caregiver burden scale and a demographics form.Results:The care burden scores were 83.2% and 80.9% in the family caregivers of inpatients and outpatients, respectively, indicating the severity of care burden for COVID-19 patients. The mean scores of objective, subjective, and subjective-objective caregiver burden were significantly higher in male family caregivers and caregivers of inpatients than in female caregivers and caregivers of outpatients [p <0.01].Conclusion:The high objective, subjective, and subjective-objective caregiver burden in family caregivers is an alarm for mental health policy-makers. Therefore, healthcare managers need to consider plans and measures to reduce the care burden of family caregivers of COVID-19 patients.

Self-Perceived Eating Habits among Family Caregivers of Older People with Dementia: A Qualitative Study

Research has suggested that family caregivers of older people with dementia often find it difficult to maintain a healthy diet due to the stress of their daily routine, putting them at increased risk of developing lifestyle-related diseases. The present qualitative study aims to clarify the factors that affect the dietary habits of family caregivers of older people with dementia. A total of 21 family caregivers of outpatients with dementia took part in interviews about their diet during a hospital visit in Japan. Qualitative content analysis was used to systematically identify ideas and patterns emerging from the interview data. The data suggest that dementia care helps family caregivers become more conscious of their own dietary lifestyle choices and increases communication opportunities. On the other hand, caregiver burden was found to have a negative influence on the quality and level of interest in dietary choices of caregivers. Providing timely and useful information on care services to family caregivers who might have hesitated to use them in the past was suggested as a useful initiative to relieve caregiver burden. This study clarified five themes related to the eating habits of family caregivers.

Development and Testing of an Audio-Visual Self-Help Yoga Manual for Indian Caregivers of Persons with Schizophrenia Living in the Community: A Single-Blind Randomized Controlled Trial.

Background:To test the feasibility and effectiveness of an audio-visual self-help audio-visual yoga manual on burden of Indian caregivers of persons with schizophrenia, living in the community.Methods:An earlier developed yoga program for caregivers of schizophrenia was remodeled into an audio-visual self-help manual in three languages and validated by mental health and yoga experts. 48 consenting primary family caregivers of outpatients with schizophrenia were screened, recruited, and allotted randomly to Yoga or Care as Usual Group. Participants in Yoga group were taught yoga from the self-help manual (1 session of 1 h every month for 5 months). The caregivers were asked to follow the manual for the remaining month at home. Assessments of burden, perceived stress, quality of life, and anxiety-depression were conducted by a rater blind to the group status at baseline and at the end of every month.Results:Post factoring for missing data, Repeatedmeasure ANOVA was conducted; which showed that there was no significant difference between the group that practiced the selfhelp yoga manual and the care as usual group. The caregivers who practiced yoga at home maintained an average of 50% attendance and “very well” level of yoga performance.Conclusion:The audio-visual self-help yoga manual was found to be feasible to use by the caregivers even though its effectiveness could not be ascertained due to high attrition.

Toplum ruh sağlığı merkezi hizmetlerinden yararlanan şizofreni tanılı hastaların yakınlarındaki bakım yükü: karşılaştırmalı bir çalışma

Purpose: In this study, we aimed to determine the care burden of the caregivers of the patients with schizophrenia taking services of Community Mental Health Center (CHMC) and to compare the results to the caregivers of the patients with schizophrenia who don’t take services of CHMC. Materials and Methods: Thirty-five patients with schizophrenia taking services of CMHC for at least 6 months and 35 patients with schizophrenia who don’t take services of CHMC. In addition, a relative (mother, father, sibling, etc.) who take care of these patients were included in the study. Sociodemographic information form was filled in for each individual and all caregivers were allowed to fill in the Zarit Caregiver Burden Interview (ZBI). Results: The total ZBI mean score of the caregivers of CHMC patients was 44.97 ± 10.24 and the total ZBI mean score of caregivers of outpatients was 52.33±14.67. There were statistically significant differences in psychological distress and deterioration of personal life, limitedness and irritability, and deterioration in social relations. Conclusion: Our results suggest that the increasing the number and functionality of CMHCs may be effective in reducing the care burden of individuals who take the responsibility for care of the patients with schizophrenia at home. These findings may guide the CHMC team that the caregiver should be involved in the follow-up and treatment process, and should be supported for the care of the patient.

Quality of Life and Caregiver Burden in Patients and Their Caregivers Undergoing Outpatient Autologous Stem Cell Transplantation Compared to Inpatient Transplantation

Quality of Life and Caregiver Burden in Patients and Their Caregivers Undergoing Outpatient Autologous Stem Cell Transplantation Compared to Inpatient Transplantation

Factors Influencing Family Burden in Pediatric Hematology/Oncology Encounters.

Caring for a child with cancer or hematologic disease places unique stress on a family unit. Families' subjective experience of this care-related burden mediates the relationship between cost and health-related outcomes. While financial costs are well described for families of pediatric hematology/oncology patients, it is unclear how cost and other factors each contribute to families' overall experience of care-related burden. This study identifies and groups the challenges that families report and describes their association with overall reported burden. This mixed-methods analysis of a cross-sectional single-center study was conducted via structured, self-administered questionnaire provided to inpatient and outpatient caregivers of pediatric hematology/oncology patients. Respondents rated their perception of burden associated with that day's medical encounter on a 5-point Likert scale. The questionnaire included an open-ended prompt for caregivers about areas they deemed most burdensome. Primary themes were extracted and categorized. A total of 278 outpatient and 42 inpatient caregivers participated. Six thematic categories emerged: logistics, life disruption, care delivery system, parking, financial burden, and emotional burden. Outpatient caregivers reported more burden than inpatient caregivers for the first three categories, while inpatient caregivers reported more burden for the last three. Salient subthemes associated with higher and lower overall burden were identified in each theme category. These data establish theme categories for future study of caregiver-perceived burden in pediatric hematologic/oncologic encounters, demonstrate that certain components of cost contribute disproportionately to caregivers' overall sense of care-related burden, and identify areas within each of the 6 burden categories that can be best targeted to alleviate caregiver burden.

Twelve Tips for Preparing a Surgical Discharge Summary: Enabling a Safe Discharge.

This article was migrated. The article was marked as recommended. The surgical discharge summary allows the perioperative care team to summarize a recent hospitalization and relay important information to a variety of invested parties including other healthcare providers, outpatient caregivers, and the surgical patient. The inpatient care team can promote a smooth transition of care and empower outpatient providers and the patient to foster a confident progression through recovery. We describe twelve tips for a streamlined, successful discharge summary geared towards the surgical intern. A successful surgical discharge summary begins with patient and caregiver collaboration, communication and teamwork, and culminates with concise documentation. These tips reflect a review of the current literature and rely on the clinical expertise of an interdisciplinary surgical team. Our aim is to empower surgical educators and trainees to understand the complexity of discharge planning, and to improve the efficiency with which it can be completed and the quality of the discharge process at their training hospitals.

Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia.

There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross-sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equationmodeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis-stress perspective. Goodness-of-fit indices (χ2 /df=1.406, GFI=0.919, CFI=0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis-stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden.

Relation Among Anxiety and Family Burden in Primary First-Degree Caregivers of Outpatients with Mental Disorders in Turkey

ABSTRACTThe aim of this study was to determine the relation among anxiety and family burden in primary first-degree relative caregivers of outpatients with mental disorders in Turkey. Data were collected with patients' primary first-degree relative caregivers via the Information Form, Beck Anxiety Inventory (BAI), and Perceived Family Burden Scale (PFBS). In all, 481 caregivers (325 women and 156 men) participated in this study. Based on this study's results, primary caregivers of patients with mental disorders had a moderate level anxiety, and as anxiety increased, family burden also increased. Those results suggest that mental health nurses should plan interventions not only for patients, but also for their family member or their caregivers to decrease anxiety level.

Caregiver stress: Clinical evaluation and intervention strategies for caregiver burden prevention.

22 Background: Caregivers (CGs) of advanced cancer patients (pts/ACPs) experience a higher incidence of medical and psychological conditions compared to general population. Methods: We conducted a prospective assessment of the caregiver burden (CGB) - a term describing the physical, psychological, emotional, social, and financial problems often experienced by CGs - to identify potential risk management strategies. We used the Caregiver Burden Inventory (CBI), a multi-dimensional questionnaire with 5 subscales: Time Dependent, Developmental, Physical, Social, Emotional CGB, as a quantitative tool to investigate the level of stress of our pts CGs. Also, we used a semi-structured interview with 5 questions as a qualitative tool. Results: From Dec 2016 to Feb 2017 we administered the CBI and the interview to 37 CGs (F/M 31/6) of ACPs in 3 different settings: inpatient (9 CGs), outpatient (15 CGs), home-based (13 CGs). The quantitative data analysis showed that CGs had a variable emotional load, mostly of moderate level. In particular, the level of stress of our pts CGs of outpatients and inpatients was higher in the physical dimension, while was higher in the time dimension for CGs of home-based pts. Semi-structured interviews showed that CGs of home-based pts did not feel adequate to provide assistance to their relatives, and had partial or poor knowledge of basic care, especially of in-bed mobilization and hygiene techniques. In the other 2 settings, CGs showed a higher level of stress due to the lack of a professional contact person throughout the care pathway, and experienced the need of psychological support. Overall, the qualitative assessment showed that CGs lives were strongly affected by caregiving. Conclusions: Our results confirm published data showing that assisting ACPs is a particularly difficult task for the CGs. Therefore, we implemented potential improvement strategies: in the home setting, specific attention to the educational aspects of basic care; in the inpatient setting, a weekly meeting for physicians, nurses, and psychologists, to discuss the most difficult cases; in the outpatient setting, a 25% increase in the number of visits for pain and supportive therapy to offer a better continuity of care.

Burnout and Related Factors in Caregivers of outpatients with Schizophrenia

Burnout and Related Factors in Caregivers of outpatients with Schizophrenia

A scoping review of caregiver burden during allogeneic HSCT: lessons learned and future directions.

The extant literature documents burden among caregivers of patients undergoing a hematopoietic stem cell transplantation (HSCT), but little is known about the burden of caregivers of patients receiving outpatient and homebound HSCTs. This scoping study sought to evaluate what is known about the burden of the increasing number of adult caregivers of patients receiving outpatient HSCTs and to create practice guidelines for how to best support this vulnerable group. Online databases were searched for studies that evaluated caregiver burden in adult caregivers of HSCT patients since 2010 (the publication date of the most recent systematic review on HSCT caregiver burden). Of the 1271 articles retrieved, 12 met the inclusion criteria, though none specifically examined outpatient or homebound caregivers. Overall, studies corroborated existing literature on the experience of significant burden among HSCT caregivers across the HSCT trajectory, and highlighted the emotional costs of outpatient transplants on caregivers and the need to identify caregivers at high risk for burden early in the transplant process. Future studies of outpatient caregivers should include a comprehensive assessment of burden and seek to identify points along the transplant trajectory at which caregivers are at particular risk for negative outcomes and when intervention is most appropriate.

A pilot, quasi-experimental, mixed methods investigation into the efficacy of a group psychotherapy intervention for caregivers of outpatients with cancer: the COPE study protocol

IntroductionDespite the rising trend of cancer prevalence and increase in family caregiving, little attention has been paid to the efficacy of psychosocial interventions among Asian caregiver samples, particularly support groups,...

Psychiatric Morbidity and Subjective Burden Among Carers of Outpatients of a Psychogeriatric Clinic in Southwestern Nigeria.

Few studies in Nigeria have investigated the burden of caring for elderly persons with mental illness. The aim of this study was to examine psychiatric morbidity and burden of care among caregivers of outpatients of a psychogeriatric clinic. Burden of care was evaluated with Zarit Burden Interview. A questionnaire was also used to elicit caregivers' sociodemographic and caregiving variables while psychological well-being was assessed with the General Health Questionnaire (GHQ). Overall, 52.3% had high care burden. High care burden was associated with financial difficulty (χ(2) = 9.37; df = 1; p = 0.002; OR = 3.1; 95% CI = 1.50-6.4), restrictions on caregivers' social activity (χ(2) = 4.87; df = 1; p = 0.027; OR = 2.4; 95% CI = 1.09-5.27), lack of support from relatives (χ(2) = 6.85; df = 1; p = 0.009; OR = 6.3; 95% CI = 1.35-29.6), physical health problems (χ(2) = 10.52; df = 1; p = 0.001; OR = 4.7; 95% CI = 1.75-12.7), and psychiatric morbidity (χ(2) = 4.05; df = 1; p = 0.044; OR = 2.62; 95% CI = 1.00-6.85). Psychiatric morbidity was predicted by physical health problems (OR = 3.0; 95% CI = 1.1-8.1), financial difficulty (OR = 17.2; 95% CI = 3.8-77.5), and job loss (OR = 5.3; 95% CI = 2.0-13.8). Care burden is a significant problem among caregivers of elderly persons with mental illness attending the clinic. This may have important implications for the mental well-being of the patients.

Ethics Outside of Inpatient Care: The Need for Alliances Between Clinical and Organizational Ethics

The norms and practices of clinical ethics took form relative to the environment and relationships of hospital care. These practices do not easily translate into the outpatient context because the environment and relational dynamics differ. Yet, as outpatient care becomes the center of health care delivery, the experiences of ethical tension for outpatient clinicians warrant greater responses. Although a substantial body of literature on the nature of the doctor-physician relationship has been developed and could provide theoretical groundwork for an outpatient ethics, this literature is not sufficient to support outpatient caregivers in practical dilemmas. For physicians who are employed by or affiliated with a larger organization, a stronger alliance between clinical ethics and organizational ethics, identity, and mission will promote expansion of ethics resources in outpatient settings and address structural constraints in outpatient clinical care.

Responsibilities and Difficulties of Caregivers of Cancer Patients in Home Care

From having been known as a virulent disease in 1970s, cancer is now considered a chronic disease and about two thirds of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care. This descriptive study aimed to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sample consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken from the university hospital; caregivers and their patients were informed about the research and their approval was obtained as well. It was found that 54.0% of caregivers helped with patient's nutrition, 50.4% with medicine use, 26.3% with oral hygiene, 26.3% with meeting urinary needs and 51.8% with changing clothes. In addition, 69.3% of caregivers helped to change bed sheets, 38.7% assisted patients to communicate with their environment and 71.5% to bring the patient to hospital or outside. In this study, it was found that Turkish caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetence in body temperature and fever control, fatigue, and lack of personal time.

Caregiver's burden and quality of life: caring for physical and mental illness

Several studies have been focused on the quality of life of caregivers caring for patients with exclusively physical or mental diseases, but little is known about the differences related to the burden experienced.This study had as its subject the burden of caregivers and their quality of life involved in helping patients with diseases (1) physical, (2) mental and (3) both pathological conditions. We interviewed 294 caregivers of outpatients undergoing physiotherapic, psychiatric and neuroriabilitative treatment. The evaluation was carried out with three instruments: an informative questionnaire, the Caregiver Burden Inventory (CBI) and the Quality of Life Index (QoL -I).Results show that both the burden and the quality of life are significantly worse for caregivers who care for patients with both physical and mental diseases. Caregivers most disadvantaged are those who indicate as a reason of care the sense of duty rather than the affection. Finally, the sons and daughters, differently from the parents, showed a greater burden of required time and a lower quality of life.The investigation of the motivational aspects of the caregivers and the increased knowledge of the differences between the emotional experience of parents and children can contribute to the definition of more specific psycho-educational interventions and support.

2574 – Relationship of family caregiver burden with quality of care and psychopathology in a sample of arab subjects with schizophrenia

Although the family burden remains one of the most important consequences of schizophrenia, no reports have addressed this important issue in the Arab world. Determine relationship of family burden with the caregiver’s/patient’s socio-demographics, clinical features and the indices of quality of care. Consecutive family caregivers of outpatients with schizophrenia were interviewed with the Involvement Evaluation Questionnaire (IEQ-EU). Patients were interviewed with measures of needs for care, service satisfaction, quality of life and psychopathology. Amongst the 121 caregivers, the higher burden scores were associated with caregiver lower level of education, patient’s female gender and younger age; patient’s lower subjective QOL and needs for hospital care; and not involving the patient in outdoor activities. Disruptive behavior was the greatest determinant of global ratings of burden. Despite generous national social welfare provisions, results underscore the need for the community-based programs and continued intervention with the families in order to improve the quality of care.

Yoga-based intervention for caregivers of outpatients with psychosis: A randomized controlled pilot study

Purpose of the studyThe use of yoga as an intervention for caregivers of patients with psychosis has been poorly studied. The current study aimed to test the efficacy of a brief yoga program as an intervention in caregivers of outpatients with functional psychotic disorders using a randomized controlled research design. Materials and methodsCaregivers who agreed to participate in the study (n=29) were randomized into yoga (n=15) or wait-list group (n=14). They were assessed at baseline and at the end of 3 months. Patients who were randomized into the yoga group were offered supervised yoga training thrice a week for 4 weeks, after which they were instructed to practice at home for the next 2 months. Due to the small sample size and some variables not being normally distributed, non-parametric statistical analysis was used. ResultsResults showed significantly reduced burden scores and improved quality of life scores in the yoga group as compared to the wait-list group at the end of 3 months. There were no significant changes in anxiety and depression scores in caregivers, or psychopathology scores in patients. ConclusionIn caregivers of outpatients with functional psychosis, 4 weeks of training followed by 3 months of home practice of a yoga module offered significant advantage over waitlist. Yoga can be offered as an intervention for caregivers of patients with severe mental disorders. Methods of providing yoga intervention closer to the community or use of flexible modules at hospitals needs further study.

Prädiktoren für die Belastung von Angehörigen Schizophreniekranker

Relatives of persons with schizophrenia have an essential role in informal caregiving. This may result in a high level of burden. Aim of the study was to investigate, if the frequency of unmet needs among relatives caring for schizophrenia patients increases the risk for burden among these relatives. 135 relatives of patients with schizophrenia or schizoaffective disorder were investigated by means of the "Involvement Evaluation Questionnaire" (IEQ) and the "Carer's Needs Assessment for Schizophrenia" (CNA-S). Multiple linear regression analyses showed positive associations between the frequency of caregivers' unmet needs and the IEQ-subscores "tension" and "worrying". Further, the IEQ-subscore "worrying" was significantly lower among caregivers of outpatients than among caregivers of inpatients or day hospital patients. The IEQ-subscore "urging" was significantly associated with patient's negative symptoms. Unmet needs among caring relatives have negative effects on their burden. Further, the patients' type of treatment setting (inpatient, outpatient, day hospital) seems to predict caregivers' burden.