Caregiver Perceptions Research Articles

Accessibility of and Barriers to Long-Term Follow-Up Care for Childhood Cancer Survivors

Childhood cancer survivorship programs and long-term follow-up (LTFU) practices are inadequate in most regions of China. To understand the clinician and caregiver perceptions of LTFU care and to identify barriers to adherence to LTFU care in mainland China. This survey study had a 2-phase sequential mixed-methods approach, consisting of a cross-sectional survey followed by semistructured interviews. Participants included oncology clinicians recruited through an educational seminar on LTFU and caregivers recruited through convenience sampling. Data were collected from November 2022 to September 2023. The clinician survey and interview focused on the standards and resources for LTFU care at their practicing institution and barriers to the coordination of LTFU care. For caregivers, the survey and interview focused on their awareness of and participation in LTFU care and their opinions on future LTFU care visits. A total of 101 clinicians (28 [27.7%] male; 73 [72.3%] female; 46 [45.6%] aged >40 to 50 years) completed the survey (response rate: 90.2%) representing 32 institutions from 22 provinces. As for the caregivers' survey, 164 eligible participants (36 [22.0%] male; 128 [78.0%] female) were recruited (response rate: 20.2%). The majority of the caregivers had received a high school or greater education (96 [56.7%]) and were parents of CCSs diagnosed with leukemia (67 [40.9%]), lymphoma or solid tumors (47 [28.7%]), or conditions requiring hematopoietic stem cell transplantation (50 [30.5%]). Most clinicians (74 [73.3%]) reported providing late effects care, yet only 10 (13.5%) had a dedicated follow-up clinic for CCSs. Two-thirds (64 [63.4%]) reported that the LTFU plan for each survivor is solely determined by their clinical judgment. In structured interviews, all doctors admitted to deviating from published guidelines due to challenges in implementing screening recommendations in their settings. Barriers to providing LTFU services included patient-related factors (76 [75.2%]), survivor knowledge deficits (61 [60.4%]), and the absence of dedicated LTFU clinics (61 [60.4%]). Among caregivers responding to the survey, 60 (36.6%) had never heard of late effects. Overall, 22 of 26 caregivers (84.6%) who participated in the interviews were not aware of potential late effects, although 17 (68.0%) could articulate existing conditions and symptoms that their children were experiencing. In this mixed-methods study involving clinicians and caregivers, substantial disparities in the uniformity and accessibility of LTFU in China were observed, suggesting the imperative need for a standardized approach to LTFU care for survivors. This includes advocating for establishment of dedicated clinics, alongside an emphasis on enhanced education and training for both clinicians and caregivers.

Determining the Care Burden and Burnout Levels of Family Members Providing Care for Cancer Patients

Objectives: Caregivers’ care burden and burnout levels are projected to increase as the physical independence of their patients decreases. This study aimed to determine the care burden and burnout perception of caregivers of cancer patients. Methods: The study was conducted with 143 patient relatives who were providing primary care for patients treated between March 1 and June 1, 2017, in the clinics of the Institute of Oncology of Istanbul University. The data were collected using the “ Personal information form “, “Zarit Caregiver Burden Scale” and “Maslach Burnout Inventory”. Data were analyzed using the SPSS statistical program. Descriptive statistics (frequency, percentage, mean, minimum, maximum, standard deviation) student t-test, one-way ANOVA, and Pearson correlation coefficient were used for data analysis. Results: The mean score from the burden interview was found 27.38±17.04. In the burnout inventory results, the mean of emotional exhaustion is 19.61±9.08, the mean of depersonalization is 8.78±5.38, and the mean of decrease in personal accomplishment is 29.66±5.91. Individuals’ perceptions of emotional exhaustion and depersonalization increase as their perception of care burden increases (p<.001). There was, however, no relationship between care burden and personal accomplishment (p>.05). The study demonstrated that caregivers’ care burden and burnout perceptions increased as cancer patients’ self-care ability worsened (p=.001). Conclusion: It has been found that the perceived care burden level is low and burnout level is middle among the caregivers of cancer patients. The patients’ level of dependency increases perceptions of caregiver burden and burnout increases too.

Clinician-caregiver informant discrepancy is associated with sex, diagnosis age, and intervention use among autistic children.

In some cases, a clinician's perceptions of a child's autism-related behaviors are not the same as the child's caregiver's perceptions. Identifying how these discrepancies relate to the characteristics of the child is critical for ensuring that diagnosis procedures are unbiased and suitable for all children. This study examined whether discrepancies between clinician and caregiver reports of autism features related to the child's sex at birth. We also explored how the discrepancies related to the age at which the child received their autism diagnosis and how much intervention they received. We found that clinicians rated autism features higher than caregivers for boys and rated autism features lower than caregivers for girls. In addition, lower clinician relative to parent ratings was related to being diagnosed at an older age and receiving less intervention. These findings suggest that there is more to learn about the presentation of autism-related behaviors in girls. When caregiver and clinician ratings of autism features do not align, it may be important to consider caregivers' ratings to obtain a more accurate picture of the child's autism features and the support they may need.

Rural Caregiver Perceptions on the Content and Receipt of a Diabetes Management Telehealth Occupation-Based Coaching Intervention.

Type 1 diabetes management for young children requires caregiver involvement to prevent serious health complications. Objectives: Explore the lived experience of rural caregivers' health management routines and perceptions of an occupation-based coaching (OBC) intervention. Following a 12-week, OBC telehealth intervention designed to promote diabetes management and caregiver psychosocial well-being, researchers interviewed eight rural caregivers to explore their perceived quality of life utilizing a phenomenological approach. Three themes emerged related to caregivers' OBC intervention needs: occupational deprivation and decreased well-being; longing for connection with social supports; and desire for knowledgeable, relatable, and accessible providers. Two themes emerged related to their experiences postintervention: satisfaction with diabetes management and psychosocial support and renewed hope for childhood normalcy. Despite drastic shift in family routines after a child's T1D diagnosis, caregivers reported acceptability of OBC for improving health management routines in a rural community following OBC intervention.

Mindfulness-based family psychoeducation intervention for caregivers of young adults with first-episode psychosis: results at 9-month follow-up.

To investigate the effects of a mindfulness-based family psychoeducation (MBFPE) intervention on caregivers and the young adults with first-episode psychosis in mental health care. Sixty-five caregivers were randomly assigned to the MBFPE program (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32). Eighteen young adults in recovery (YAIR) also participated in the study. All of the participants completed the assessments before participating in the intervention (T1), after the intervention (T2), and at 9-month follow-up (T3). Intention-to-treat analyses were conducted. The caregivers reported a significant and large effect size on positive caregiving experiences based on a Time × Group analysis (g = 0.862, p = 0.006). Among the YAIR participants, between-group differences were significant in their perceptions of caregivers' expressed emotions, including large effect sizes of perceived criticism (g = 1.396, p = 0.049) and hostility (g = 1.444, p = 0.043). Caregiver demographics, including age, education level, socioeconomic status, and number of family members, were found to moderate the effect sizes of the variables studied. This study provides evidence of the effects of MBFPE programs on the outcomes of caregivers and the young adults with first-episode psychosis in their care. Specifically, the MBFPE program in this study played a greater role in promoting positive caregiving experiences and changing caregivers' expressed emotions, especially their expressed criticism of YAIR, compared with the regular FPE program. Therefore, the application of mindfulness training to promote family care and YAIR recovery should be encouraged. ClinicalTrials.gov, identifier NCT03688009.

Caregivers of children with asthma alarmed by climate change: a cross-sectional study.

Climate change poses significant health risks, with children being particularly vulnerable to its adverse health effects. Children with asthma are expected to have worsening disease due to increased exposure to heat, air pollution, mold from flooding, and pollen. Understanding caregiver perspectives on these health harms is crucial for informing public health policy and education. Therefore, we aimed to explore caregiver perceptions of climate change-related health risks to children with asthma. In this cross-sectional study, a survey instrument was created and distributed to caregivers of children with asthma during their visits to pulmonology clinics located in an urban northeastern US setting and via email. Among 198 completed surveys, 78% of participants reported high levels of concern about climate change, with most respondents agreeing that climate change has already impacted their child's health. Examples provided by respondents included worsening asthma control due to air pollution, wildfire events, pollen exposure, and rapid changes in weather. Respondents who self-identified as female had greater concern. Most respondents agreed that these topics should be further discussed with their child's doctor. Although, barriers to such discussions were noted by the respondents. Caregivers of children with asthma have high levels of concern regarding climate change and report adverse impacts on their child's asthma. Clinicians caring for children with asthma should consider discussing the respiratory health impacts of climate change with caregivers. However, barriers to these discussions need further examination.

Follow-up care experience of patients with invasive meningococcal disease and their family caregivers: a qualitative study

BackgroundClinical guidelines recommend systematic follow-up of patients surviving invasive meningococcal disease (IMD) to assess sequelae. However, little is known about survivors and family caregivers’ experiences of the follow-up care. Study sought to explore IMD survivors’ and their family caregivers’ experiences after hospitalization for IMD and to identify unmet needs.MethodsSemi-structured interviews were conducted with patients and family caregivers, identified through hospitals database. Interviews were audiotaped, transcribed and subject to a thematic analysis. NVivo software was used for data management and analysis.ResultsEight IMD survivors and 14 family caregivers were interviewed. Three themes were identified from the data: (1) perception of patient and family caregiver on follow-up after IMD and role of healthcare professionals; (2) access to care and support; (3) relationship with healthcare professionals. Although most were satisfied with follow-up care after IMD, suggestions for improving the healthcare pathway were made relating information on potential sequelae and follow-up care, coordination, and access to psychological support.ConclusionsThis study confirms the need for more structured follow-up care for patients suffering from IMD and their families which is currently limited and focused on physical recovery. Optimal follow-up should aim to provide sufficient information, emotional support and logistical support for patient and family caregivers.Trial registrationEthics Committee of University of Lyon, France (ref: 2022-06-23-002).

Caregiver Perceptions of the Social and Emotional Characteristics of Gifted Children From Early Childhood Through the Primary School Years

ABSTRACT Caregivers play an important role in the development of talent in high-potential children, however, limited research exists on their observations and perceptions of their child’s development. The purpose of this exploratory study was to examine caregivers’ perceptions of the social and emotional characteristics of gifted children in grades K–3. Semistructured interviews were held with a purposive sample of 11 caregivers of intellectually gifted children between the ages of 5 and 9. A thematic analysis revealed two overarching themes: (a) sensitivities and intensities, and (b) behaviors associated with challenges at home and school. Participants also completed questionnaires on personality factors and overexcitabilities. A hierarchical cluster analysis and k-means cluster analysis indicated that highly and profoundly gifted students scored higher in the five Dąbrowskian overexcitabilities as well as openness to experience. Implications are discussed for research and practice.

A - 88 Grandparent Caregivers Interaction with Experiences of Discrimination Effect on Perceptions of Cognitive Control

Abstract Objective This study hypothesized that perceptions of cognitive ability control will differ according to grandparent caregiving status and perceptions of discrimination based on age. Control beliefs mediate the relation between discrimination and executive function. Due to the intersectional nature of grandparents who raise grandchildren and minority statuses compared to non-caregiving grandparents, it is thought that perceptions of age being the main reason of discrimination will differentially affect caregiving grandparents compared to non-caregiving grandparents perceptions of control over cognitive ability. Method Data included 92 caregiving and 407 non-caregiving grandparent participants from the third wave of a longitudinal data collection survey Midlife in the United States study (MIDUS III). MIDUS III included self-administered surveys assessing caregiver status, perceptions of main reasons of discrimination, and perceptions of cognitive control. Result A 2-way ANOVA was performed to analyze the effect of grandparent caregiver status and age discrimination perceptions on perceptions of cognitive ability control. A 2-way ANOVA revealed there was a significant interaction between the effects of grandparent caregiver status and perceptions of aging discrimination (F(1, 498) = 7047, p < 0.001). Conclusions Grandparent caregivers are more likely to have higher perceptions of control over cognitive ability when they do not perceive age as a main reason for discrimination; whereas non-caregiving grandparents have higher perceptions of control over cognitive ability when they do perceive age as a main reason for discrimination. Perceptions of why individuals are discriminated against may interact with personal factors that contribute to perceptions of control in cognitive ability.

Measuring Perceptions of School Lockdown Drills: Development and Validation of the Lockdown Impact Scale for Caregivers (LIS-C)

Understanding the extent to which caregivers perceive active shooter lockdown drills in K–12 schools as physically and emotionally safe for their children is pertinent, yet little empirical evidence exists. Negative parental perceptions of drills can lead to decreased student participation and compliance and amplify public concerns associated with school safety. This article introduces the Lockdown Impact Scale for Caregivers (LIS-C), a novel instrument developed to assess caregiver perceptions of K–12 school lockdown drills. Utilizing a national sample of 999 caregivers, this study validates the LIS-C through exploratory and confirmatory factor analyses, revealing a three-dimensional construct that includes perceived impact, school safety, and expressed concern. The development and validation of the LIS-C provide school-based mental health professionals with a psychometrically sound tool to address caregiver concerns, paving the way for a more informed and intentional implementation of lockdown drills. This research underscores the pertinence of examining caregiver perceptions to foster a safer and more supportive school environment.

Careers and Quality of Life: Comparing Perceptions of Compound and Noncompound Caregivers

Study objectives were to compare differences in quality of life (QOL) and family quality of life (FQOL) between compound and noncompound caregivers and describe how career-related dimensions influence the global FQOL. Examination of survey data from 77 compound and 113 noncompound caregivers indicated that compound caregivers had lower QOL, global FQOL, and worse career outcomes than noncompound caregivers. Global FQOL was associated with greater career satisfaction, higher income, and noncompound caregiver type. For compound caregivers, global FQOL was associated with more career opportunities and positive perceptions of career stability. These findings have implications for supporting career pursuits of family caregivers.

Tracheostomy Decision Making and Counseling: Comparing Providers' and Caregivers' Perspectives and Perceptions.

Background: The decision to place a tracheostomy in children is complex and involves factors beyond the medical procedure, including quality of life, values, and goals. Providers play an important role in counseling caregivers and guiding them through the decision-making process. There are no established guidelines for tracheostomy counseling, leading to variations in practice. Additionally, how caregivers receive information differs from how providers believe they deliver it. Although studies have explored caregivers' and providers' viewpoints, none have examined them concurrently. Background: The primary aim of this exploratory study is to investigate differences between providers' and caregivers' perceptions of tracheostomy counseling and their perspectives regarding the decision-making process. Design: Semi-structured interviews were conducted with both caregivers and providers for children being evaluated for a tracheostomy. Qualitative analysis was applied to the interview transcripts to identify emergent themes. Subsequently, a comparative analysis was performed to compare these themes between caregivers and healthcare providers. Results: A total of 33 interviews were conducted, involving 16 caregivers and 17 providers. Notably, caregivers provided personal descriptions of their children in 81% of cases, whereas only 35% of providers did so. Concerns and fears for the children were expressed by 69% of caregivers and 59% of providers. In contrast, 75% of caregivers discussed their hopes and dreams for their children, compared with only 29% of providers. When it came to priorities, 69% of caregivers emphasized growth and development, and 38% mentioned discharge home, as opposed to 29% and 47% among providers, respectively. Conclusion: In conclusion, our study highlights a disconnect between caregivers and healthcare providers regarding tracheostomy counseling. These differing perspectives underscore the need for improved communication and understanding between the two groups. Recognizing these differences can help providers tailor their counseling approaches to better align with the values and priorities of families when making decisions about tracheostomy.

Group-based medical mistrust in genomic medicine: Associations with patient and provider perceptions of a specialty clinical encounter

PurposeInvestigating associations between group-based medical mistrust (GBMM) and perceptions of patient-provider encounters can identify one mechanism through which GBMM may influence health outcomes and serve as a barrier to equitable health care. This study investigated associations between GBMM reported by caregivers of children with a possible genetic condition and caregivers’ and providers’ perceptions of a specialty care appointment discussing diagnostic plans. MethodsCaregivers (N = 177) completed the GBMM scale and other measures before their child’s initial specialty clinic visit. After the visit, they reported their perceptions of the visit, including patient centeredness and satisfaction with care. Providers (N = 6) reported their perceptions of patient engagement. ResultsMultivariable linear regression showed that higher caregiver GBMM was associated with caregivers’ lower satisfaction with care (P < .01) and more negative perceptions of every domain of patient centeredness (P = .001-.04). Multilevel modeling showed that higher caregiver GBMM was associated with more negative provider perceptions of caregivers’ preparedness to participate in care (P = .03), likely treatment compliance (P = .03), and relevance of questions asked during visit (P = .04). ConclusionOur findings extend evidence for detrimental effects of GBMM on patient satisfaction to caregivers of pediatric patients and offer new evidence for associations with health care providers’ perceptions of caregivers’ engagement with care.

Perceptions of Children and Caregivers Regarding Asthma and Its Pharmacotherapy: A Qualitative Study.

Asthma, when untreated, may lead to serious implications, especially in the pediatric population. Understanding the perceptions and needs of children and their caregivers may optimize asthma management. This study was aimed to analyze the perceptions of children and their caregivers regarding asthma and its pharmacotherapy. This is a qualitative study using 2 focus groups. We use the Bardin's content analysis. Three researchers made data cross-validation. As for results, the first focus group comprised 7 children who had uncontrolled asthma. The second group comprised 7 caregivers who were the children's mothers. Four categories emerged: living with asthma, impact of asthma, medications, and health care. Asthma and its pharmacotherapy significantly affect the daily activities of children and mothers. Thus, understand feelings and experiences of patients and caregivers, in addition to educational and welcoming interventions for families in asthma management may be carried out by health care professionals to minimize the damage caused by this disease.

Dietary Needs, Barriers, and Facilitators Among Patients on Hemodialysis and Their Caregivers: The GoodRENal Project in Spain

ObjectiveDietary restrictions are common in patients undergoing hemodialysis (HD). These restrictions result in a complex diet that becomes difficult for patients to understand and to follow. Therefore, we aimed to identify dietary needs, and barriers and facilitators that influence the adherence to dietary recommendations as perceived by patients on HD and their caregivers. MethodsSeventy-two Spanish patients on HD and fifty-seven caregivers participated in this explorative study by replying a questionnaire consisting of 20 and 10 questions respectively. The responses were assessed using a Likert scale varying from 1 to 5 (strongly agree, agree, neither disagree or disagree, disagree, strongly disagree, respectively) to evaluate the perception of patients and caregivers regarding dietary needs, barriers and facilitators to adhere to the recommended diet. For analysis purposes, the responses were grouped in three categories (agree, neither agree or disagree, disagree). ResultsSeventy percent of the patients agreed that knowing the food sources of potassium, protein and phosphate was a need for them to know to be able to adhere to the dietary recommendations. Moreover, patients stated that not being able to eat what they liked, and feeling thirsty, were important barriers. For caregivers, the support of a renal dietitian was mentioned as an important facilitator to assist those they cared for to adhere to the diet. ConclusionsKnowing food sources of potassium, phosphate, and protein, exploring foods patients like to eat and adjusting fluid intake to avoid feeling thirsty were identified as important by the patients. These findings can be used to develop strategies and educational material to improve the dietary adherence in patients undergoing HD. Moreover, the presence of a renal dietitian was identified as an important resource by the caregivers.

Caregiver Perception of the Oral-Health-Related Quality of Life of Children with Special Needs: An Exploratory Study.

Compared to the general population, individuals with special needs tend to have worse oral health, potentially diminishing their quality of life. This study aimed to evaluate the perception of parents and caregivers regarding the effect of oral health on the quality of life of individuals with special needs who received dental treatment under general anaesthesia, as well as the impact on their and their families' quality of life. This cross-sectional study involved participants with special needs who had undergone a dental treatment under general anaesthesia. Before the intervention, an oral examination was conducted to count the number of teeth affected by caries. Parents or caregivers filled out a specially designed questionnaire that included sociodemographic information, details about the children's oral hygiene and dietary habits, and questionnaires on the impact of their child's oral health on their quality of life (P-CPQ) and the influence of the oral health of children with psychophysical difficulties on the family (FIS). The data collected were analysed both descriptively and using the chi-square test, Fisher's exact test, Kruskal-Wallis test, and Spearman's correlation analysis. The level of significance was set at p ≤ 0.05. This study involved 42 children (24 females and 18 males) with an average age of 21.14 ± 8.34 years. The average number of carious teeth per participant was 9.74 ± 5.63. About 66% of respondents reported that their children performed oral hygiene with their help, while 9.5% of them did not do so at all. Individuals with a higher number of caries had statistically significantly higher scores on the emotional well-being (p = 0.004) and social well-being (p = 0.033) subscales of P-CPQ, as well as on the parental emotions subscale of FIS (p = 0.020). Also, there was a difference in the number of carious teeth in participants due to unhealthy habits (drinking sweetened beverages, p = 0.030) and due to comforting with food (p = 0.004). The increase in the number of carious teeth in individuals with special needs has been associated with the quality of life of their families. To address this, it is crucial to promote the prevention of oral health issues by educating individuals with special needs and their caregivers on proper oral hygiene techniques and diets tailored to their specific requirements.

Caregiver and Care Team Perceptions of Online Collaborative Care Planning for CMC.

Care plans summarize a child with medical complexity's (CMC) medical history and ongoing care needs. Often, the health care team controls the care plan content, limiting caregivers' ability to edit the document in real time and potentially compromising accuracy and utility. With this study, we aimed to provide caregivers of CMC with online access and shared editing control of their child's care plan and to explore the experiences of caregivers and care team members (CTMs) after using an online collaborative care plan (OCCP). Caregivers of CMC were recruited from a tertiary complex care program to use an online, patient-facing platform for 6 months, which included the ability to edit and share their child's care plan. Caregivers and CTMs participated in semi-structured interviews to explore their experiences in using the OCCP. Consistent with grounded theory methodology, a constant comparative analysis was used, which allowed for theoretical sampling and theory generation. A total of 15 caregivers and 20 CTMs completed interviews. Interviews revealed 3 major themes and 9 subthemes, including (1) the navigation of uncharted roles (trust, responsibility), (2) the requirements for success (electronic medical record integration, online access, collaborative care plan review), and (3) cohesive care (accessibility and convenience, being on the same page, autonomy). Themes informed the creation of a theoretical model for the implementation and utility of OCCPs. Online, collaborative care plans, when implemented safely and thoughtfully, promote shared understanding, improve caregiver autonomy, and increase the accessibility of health information. Together, these benefits facilitate cohesive care and authentic partnership between caregivers and CTMs in the care of CMC.

Investigation of current clinical practices and perceptions of patients and caregivers regarding Alport syndrome in South Korea.

Alport syndrome (AS) is a highly prevalent inherited kidney disease. Early diagnosis and intervention are crucial for improved kidney outcomes. This study evaluated awareness among Korean clinicians about AS and assessed the understanding of AS patients and caregivers. An online survey targeting registered members of the Korean Society of Nephrology, the Korean Society of Pediatric Nephrology, AS patients, and their caregivers was conducted from January to April 2023. Out of 103 respondents, most had treated fewer than 10 AS patients. For certain kidney diseases, such as chronic kidney disease of unknown origin and focal segmental glomerulosclerosis, half or fewer considered AS as a potential diagnosis. Only half preferred immediate confirmation tests for suspected AS. Genetic testing was available at half of the medical centers, and fewer than half of the adult nephrologists considered genetic testing to be essential. While all the surveyed nephrologists would prescribe renin-angiotensin system blockade, the majority hesitated to initiate treatment. Vigilant genetic testing for donor candidates was not a common practice. While 80% of patients and 50% of caregivers understood the nature and prognosis of AS, they regretted the delayed diagnoses, insufficient explanations, and the absence of support groups. Not rarely, AS patients may have been unrecognized as AS. Despite the noteworthy advancement of AS, the recent guidelines have not been widely adopted in clinical practice in Korea. Considering the challenges in Korea, there is an urgent need for locally tailored clinical practice recommendations and a dedicated registry to optimize patient outcomes.

Inclusive playgrounds: Caregiver perceptions of accessibility and use

This descriptive qualitative research aimed to explore the caregivers’ perceptions of children’s social and physical accessibility in inclusive playgrounds. The researchers conducted 11 in-depth interviews with caregivers regarding their perceptions of the accessibility and use of an inclusive playground by children with disabilities and how they perceive interactions between children with and without disabilities while using the playground. From the interviews, two major themes emerged. The first major category was physical accessibility, with three minor themes emerging: a) safety and physical accessibility; b) sensory and cognitive safety; and c) variety and options; and the second major category was social accessibility, with two minor themes: a) social interactions; and b) building friendships and practicing social skills.Overall, the participants in this study described the inclusive playgrounds as safe places that include varied play equipment, which encouraged children with and without disabilities to play together, interact verbally, and build immediate friendships. The findings highlight the importance of inclusive playgrounds as a starting place for enhanced community relationships. The researchers suggest conducting further research that focuses on children’s perceptions and including a broader range of children with varying disabilities using inclusive playgrounds.

Perception of caregivers regarding the sexuality of older adults in a long-term care facility

Longevity, although a relevant aspect of human achievement, still brings unknown dynamics between the older person and their world, particularly in what regards to issues related to sexuality, which faces social stigmas. This study aims to analyze the perception of caregivers about the sexuality and sexual autonomy of the older adults in a Long-Term Care Institution. This a descriptive and exploratory study, with a qualitative approach. Semi-structured interviews were conducted with the caregivers, followed by Content Analysis by Laurence Bardin. The perceptions of the caregivers are permeated by social stigmas and sociocultural beliefs, expressed, for example, in the difficulty of defining the word sexuality, association between senility and senescence, denial of sexuality in aging, perpetuation of patterns of paternalism and infantilization of the older adult, in addition to conflicts between institutional rules and religious views of family and marriage.