Caregiving Practices Research Articles

Complementary feeding practices of mothers and caregivers of under-fives in Sokoto, North-Western Nigeria

Background: Adequate complementary feeding entails feeding children aged between 6 and 23 months with foods from four or more food groups at least thrice a day. In introducing complementary feeds, mothers or caregivers adopt various feeding practices which may not comply with standards for optimal infant feeding. Objective: To assess the complementary feeding practices of mothers and caregivers in Sokoto, North-western Nigeria. Methods: A cross-sectional survey of consenting mothers/caregivers selected through multistage random sampling. Data was obtained using an interviewer-administered questionnaire adapted from a WHO document on indicators for assessing infant and young child feeding practices, and was analyzed using SPSS version 25. Results: A total of 353 respondents with a mean (±SD) age of 28.8 ±6.1 years were interviewed. Most 330(93.5%) of the respondents were married and had ≥3 (77.9%) numbers of children. Most (50.7%) of the respondents had no formal education and majority (80.5%) were petty traders. They were mainly 180(51.0%) of low socio-economic status. Most 185(52.4%) of the respondents introduced complementary feeds (CF) before six months and mainly 182(53.1%) in the form of guinea corn gruel. Carbohydrate based feeds were the most 335(94.9%) consumed form of family diet. The minimum nutrient diversity and frequency were met in only 96(27.2%) and 217(61%) of the children, respectively. The minimum acceptable diet was unmet in the majority 285(80.7). Socio-economic class (p=0.002) and community setting (p=0.003) were associated with respondents feeding practices. Middle socio-economic class (p=0.009) and urban community setting (p=0.002) were independent predictors of timely initiation of CF. Conclusion: Majority of the respondents practiced early initiation of complementary feeds. The minimum acceptable diet was unmet in the majority of the children. Socio-economic class and community setting were associated with complementary feeding practices.

The effect of oral healthcare education on caregivers of physically and mentally disabled individuals

Background: Special physical and mental conditions of disabled individuals are burdens to their utilization of proper oral healthcare. Their caregivers can be influential in improving their oral health status. This study sought to assess the effect of oral healthcare education on the knowledge, attitude, and practice of caregivers of physically and mentally disabled individuals. Methods: This quasi-experimental study evaluated 68 caregivers of physically and mentally disabled individuals selected from disability rehabilitation centers in Tehran by convenience sampling. A validated questionnaire was designed for data collection, including questions on demographics, knowledge, attitude, and practice of caregivers. A brochure was also designed to cover the content of the educational intervention, and the relevant topics were taught to caregivers using the face-to-face method. A pretest-posttest method was used for effectiveness assessment. All the caregivers filled out the questionnaire before and 3 months after the educational interventions. The pretest and posttest scores were compared using the Wilcoxon test and paired t test. Results: Sixty-three caregivers participated in this study, 80% of whom were women and 94% had more than one year of work experience. The results showed that the mean score of their knowledge (from 1.2±0.82 to 4.82±0.35), attitude (from 2.38±0.69 to 5.61±0.75), and practice (from 0.59±0.41 to 4.93±0.65) increased significantly after the intervention, which indicates the effectiveness of the intervention (P<0.001). Conclusion: Educational intervention can significantly enhance the knowledge, attitude, and practice of caregivers of physically and mentally disabled individuals. This can, in turn, help improve the oral health status of the disabled individuals under their care.

Oral health perceptions and practices of caregivers at children’s religious schools and foster care centers: a qualitative exploratory study in Lahore, Pakistan

BackgroundOral diseases are one of the major public health problems worldwide and affect the population of all age groups. This qualitative study aimed to explore the perceptions and practices of caregivers at care centres and boarding religious schools responsible for managing children’s oral health.MethodsA qualitative ethnomethodological approach was used to collect data from the caregivers at the children’s religious schools and foster care centres. A purposive sampling technique was used to conduct focus group discussions comprising 4–7 caregivers from five foster care centres and religious schools located in Lahore, Pakistan.An interview guide was developed based on results from previous studies. An inductive approach was used to analyse data on broader oral health concepts to generate themes in this qualitative research. A three-step thematic analysis was applied to develop codes that were merged to generate categories and to conclude into themes from the transcribed data. Five focus group discussions were conducted at two foster care centres (FG1 & FG2) and three religious schools (FG3, FG4 & FG5). Foster care centres had children of both gender within the same premises; however, religious schools had segregated settings.ResultsThe following four themes emerged from the thematic analysis: development of the desired living environment and responsibilities of the caregivers, preexisting traditional personal knowledge of the caregivers determine children’s oral health, use of religio-cultural driven and convenience-based oral hygiene practices, and ethnomedicine, spiritual healing, and self-medication. Development and the existing living environment of the foster care centres and religious schools appeared important to manage the matters of the boarding children.ConclusionsThis qualitative study concludes that the oral health of the children at foster care centres and at religious schools depends upon the personal reasoning and pre-existing religio-cultural knowledge of the caregivers rather than on specialized oral health-oriented approaches. The foster care centres are more involved in supervising the children to maintain oral hygiene and oral health compared to religious schools.

COVID-19 Vaccination Experiences of Family Caregivers of Persons Living with Dementia in Rural Appalachia.

The study investigated COVID-19 vaccine acceptance, hesitancy, and barriers among family caregivers of rural community-dwelling persons living with dementia (PLwD). Three waves of telephone interviews with 26 family caregivers (96% White, 81% Female, Mage = 63 ± 12 years) were analyzed using thematic content analysis. At Wave 3, although all dyads were eligible, only 10 dyads had received their first dose of the vaccine. In 10 dyads, neither person had received the vaccine; in2 dyads, the caregivers did but the PLwD did not; and in 4 dyads, the caregiver did not but the PLwD did. Perceived direct and indirect health risks, cues from trusted allies, and ability to overcome vaccination barriers affected COVID-19 vaccination acceptance. Vaccine refusals were motivated by a low perceived risk of COVID-19, vaccine fear, and personal beliefs. Findings have implications for administration of preventative care practices for dementia family caregivers living in remote locations during a public health emergency.

A Disembodied Dementia: Graphic Medicine and Illness Narratives.

The dominant discourse on dementia promotes a view that as individuals progress with the disease, they experience a neurological decline causing a loss of self. This notion, grounded in a Cartesian representation of selfhood, associates a loss of self as directly related to cognition. This paper presents an alternative anthropological framework, embodied selfhood, that challenges this representation. It then examines a potential tool, graphic medicine, to translate this theory into caregiving practice. Through analyzing three graphic novels-Wrinkles, Tangles, and Aliceheimer's-this paper demonstrates how tension exists between different conceptions of selfhood and associated implications for caregivers and patients alike.

GENDER DIFFERENCES IN CAREGIVING PRACTICES AND MARITAL RELATIONSHIPS OF SANDWICH GENERATION COUPLES IN MUMBAI

Abstract Over the next few decades, the most important demographic trend for the Asia Pacific region will be population aging. The increasing aging population in India and the fact that the economic dependence of the older adults is high and the cost of education and child care is on the rise pose serious challenges to generations of individuals and couples who are expected to take care of both their children and their parents. This study's primary objective is to comprehensively understand the effects of giving care to their children and their parents on various aspects of the life of sandwich generation couples. The study uses primary data of 300 multigenerational households and 100 two-generation/one-generation households in Mumbai. Specifically, the study attempts to understand the effect of giving care to two generations on the marital relationship of the caregiving couples. Additionally, the study also explores gender differences in caregiving practices. Results from bivariate and multivariate analyses show that providing simultaneous care to two generations significantly impacts the marital relationship of the sandwiched couples as opposed to couples staying in one/two-generation households. Results also show considerable gender differences in caregiving roles and time spent on caregiving. Women spend more time assisting in household activities, while men are more likely to provide monetary support. Thus, extensive research on the sandwich generation in India is necessary to ensure the socio-economic well-being of the couples, the welfare of their children and parents, and the physical and psychosocial health of these couples.

CHANGING FAMILY DESTINIES, DIVERGENT FAMILY CAREGIVING PATTERNS: DO BIRTH COHORTS, GENDER, RACE, AND SES MATTER?

Abstract Over the past few decades, Americans have experienced a series of demographic transitions include prolonged longevity and rise in the complexities of family structures. The Baby Boomer cohort is at the forefront of these transitions, which has profound implications on their later-life family relations and practices of family caregiving. Most caregiving literature has focused on static care experiences over a short time, while neglecting long-term care experiences. Using 10 waves of longitudinal data from HRS (2000-2018) and latent profile analysis, I identified five prominent long-term caregiving patterns: light parental caregivers (44.1%), intensive spousal caregivers (5.6%), sandwiched caregivers (5.5%), light grandchildren caregivers (38.7%), and heavy grandchildren caregivers (6.2%). Further, I conduct multinominal logistic regression to investigate how birth cohorts, gender, race, and education shaped these patterns. Results suggested that later cohorts have seen a decline in intensive spousal caregivers, light and heavy grandchildren caregivers, but an increase in light parental caregivers. Women are more likely to be sandwiched caregivers than men, and black caregivers are more likely to be intensive spousal caregivers, heavy grandchildren caregivers, and sandwiched caregivers than white. By contrast, white and more educated caregivers are more likely to be light parental caregivers, and this pattern becomes more pronounced in later cohorts. The findings suggest divergent destinies of family caregiving patterns among later cohorts. More disadvantaged groups are shouldering heavier care responsibilities than advantaged groups. Targeted care services should be implemented to ease the care burdens of the vulnerable population.

CONTEXT AND TRUST: DIRECT CARE WORKER RELATIONSHIPS, CARE PRACTICES, FACILITATION, AND IMPLEMENTATION OF INNOVATIONS

Abstract This paper examines the relationships between Direct Care Workers (DCW) and other nursing home (NH) staff. Specifically, we examine how trust, and the context in which trust exists, influences care practices and implementation of innovations in NHs. This secondary analysis of interviews and field observations from three separate NHs in different Canadian provinces shows differing levels of trust that between HCAs and other staff. We also analyze the organizational context can mediate trust in these relationships. Specifically, we analyzed trust DCWs have at the interpersonal, institutional, organizational levels and what ways they act as facilitators of programs aimed at improving care practices health outcomes of residents in NHs. Using the Alberta Context Tool’s dimensions of organizational context as a framework, this research shows how trust in the relationships between DCWs and other LTC staff influences caregiving practices and the uptake of new innovations.

Knowledge, Attitude and Practices For Nutrition And WASH Among Care Givers Of Children Under 5 Years Old In Hajjah And Hodeidah Governorates, Yemen

Background: Appropriate feeding is important in improving nutritional status & child survival. UNICF reported that malnutrition due to food insecurity in Yemen is alarming (> 15%). The water situation in Yemen is in severe crisis and 50% of Yemen's population does not have access to safe drinking water or sanitation. The aim of this study was to identify knowledge, attitude and practices of caregivers toward nutrition and WASH of their children under 5 years old in Hajjah and Hodeidah governorates, Yemen. Methods: This was a KAP study with two-stage cluster sampling using the nutrition survey model. The principal tool to understand or define previous and current KAP towards recommended nutrition and WASH practice followed nutrition survey model which was adopted from the UNICEF’s guideline for assessing nutrition. KAP survey assesses both the short-term outcomes of social behavior change activities like a change in knowledge or attitudes but also the medium and long-term outcomes, such as a change in actual behavior and the resultant practices. Results: There is good knowledge on breastfeeding, and its initiation within one hour after birth; and the breast milk ideal food for 0-6 months aged child. However, benefits of breastfeeding on mother is absolutely unknown by 39.9%. Average duration of breastfeeding is 18.5 months; however, cease of breastfeeding among 42.1% mothers was due to lack of breast milk. Only 1 in 5 children received daily 4+ items of food which indicates low rate of minimum diet diversity. 44% of households are using unprotected wells as a main source for their domestic/drinking water needs. In addition, there is potential contamination of water during handling inside house that highlights importance of providing more training about water handling at household level. Open defecation is practiced by 57.9% of households, 53.6% dispose the wastes behind the house. Overall 38.46% of HHs have latrines. About half of women wash hands after using the toilet, 38.2% before cooking, 65.7% before eating and 35.5% before feeding the child. No hand-wash premises among almost all households. Conclusion: There is a positive return on good nutrition practice and WASH practices of DRC investment.

Vers la compréhension des demandes d’aide à mourir de résidents d’EHPAD. Une étude qualitative multicentrique

ContextMoving into a nursing home is the cause of considerable upheaval for the elderly. The end of life is a reality in these establishments and residents are regularly confronted with it. Death is part of life in a nursing home and at the same time, it is one of the least discussed subjects due to avoidance strategies. The desire to die can take many forms, from suicide to refusal of care, and it is studied in particular through an analysis of requests for euthanasia and assisted suicide. The studies conducted on this subject show that the wish to die is a request expressed by a significant number of patients at the end of their life, regardless of the legislation adopted by the countries. Few studies have analyzed the demand for euthanasia or assisted suicide in a country where it is prohibited. ObjectivesA qualitative study is needed to provide an in-depth analysis of the expressions used by residents who make a request for euthanasia or assisted suicide, in the specific context of nursing homes. The DESAGE study (Demandes d’Euthanasie et de Suicide Assisté des personnes Âgées) is a multi-centric qualitative study which aims to describe, analyze, and understand, through semi-directive interviews, the determinants of requests for euthanasia and assisted suicide among residents of these facilities. This research is part of a comprehensive approach to these requests based on the residents’ verbatim statements. Patients, materials and methodsThe data collection was carried out in several nursing homes in a region of eastern France near Switzerland. For inclusion in the study to be effective, explicit requests for assistance in dying had to be made to health professionals. Following inclusion, an initial semi-directive interview of the resident was conducted. A second interview took place several weeks later to understand the timing of such a request. The analysis of the data followed the logic of thematic content analysis. ResultsData collection took place from May 2019 to July 2021 in seven nursing homes in France. Seven situations were explored. These testimonies shed light on the reality of a little-investigated field and highlight meaningful life pathways. The testimonies of these individual inform us about the requests for euthanasia and assisted suicide that are made, and undeniably place them in a singular context. Suffering, whether physical or psychological, is present in the statements and death is perceived as the only solution to relieve this suffering. Multiple factors underlie it: dependence, the difficulty of finding meaning in one's current life, loneliness, the feeling of boredom, the impression of being a burden on one's loved ones. It is also linked to the fear of a deterioration of the physical state and the apprehension of the conditions at the end of life. It is rooted in an experience marked by successive, sometimes brutal, losses: physical losses linked to ageing, the loss of autonomy, the loss of reference points in the initial environment when entering a nursing home, and in some cases the loss of a spouse or main caregiver. ConclusionIt would be relevant to introduce into the daily practice of caregivers the implementation of more tools that promote, for example, the deployment of the function of restraint. Focusing on taking care of the body could be an illustration of this, because when we enhance the body, we also enhance the psyche. Moreover, the analysis of the discourse makes it possible to provide the caregivers with keys to understanding. It is an assignment to find common issues in the exchange. It is in this space of speech that the answers can be found and that an importance is given to the understanding of a common construct. The speech of a person who asks to die is an attempt to express the unspeakable, an attempt to express a singular suffering. It is essential to question the function of speech, what is at stake, and to train caregivers to confront these issues.

Knowledge, attitudes and practices about physical restraints in caregivers of geriatric centers in the city of Cuenca

BACKGROUND: The use of physical restraints as a means aimed for partial or general immobilization, in a patient who requires it to try to guarantee his or others safety, in hospitals and long-term residences, has been widely documented and discussed. The aim of this study was to evaluate the knowledge, attitudes and practices about the use of physical restraints of caregivers in geriatric centers in the city of Cuenca, during 2018. METHODS: Descriptive, observational, cross-sectional study in which a survey was applied to 60 caregivers of older adults from 6 geriatric centers in the city of Cuenca-Ecuador. The questionnaire we used, prepared by Suen KPL, evaluated the knowledge, attitudes and practices of caregivers regarding the use of physical restraints. Data was tabulated with SPSS version 22.0 software, percentages and frequencies were calculated; we used Fisher`s exact test searching for statistical association between the relevant variables. RESULTS: 75% of the caregivers in the study population were in a range of 20 to 39 years of age. Of all the participants, 90% were nursing assistants. Regarding knowledge, 66.7% of the participants had intermediate knowledge; only 10% had high knowledge. 83.3% of the participants had negative attitudes regarding physical restraints. Most of the population (68.3%) had very satisfactory practices. CONCLUSION: The caregivers of older adults in the geriatric centers studied in the city of Cuenca are mostly nursing assistants. There is a knowledge deficit in 23.3% of all caregivers. Most of the caregivers presented negative attitudes regarding the use of physical restraints. In relation to the practices, in general, we found a very satisfactory level. With the results obtained, we concluded that there is no significant statistical association between the professional characteristics of the caregivers and the knowledge, attitudes and practices about physical restraints.

Recommendations for parents and caregivers of children at risk of gambling in light of systematic review of literature

The cognitive goal of this article is to provide the knowledge needed to strengthen the educational and preventive competencies of parents and caregivers in the prevention of gambling disorders in children and adolescents. The practical goal, therefore, is to formulate recommendations for parents and caregivers in the upbringing and prevention of gambling disorders in the family and peer environment. The article is a review. This article, which is aligned with theme of the journal, refers to research on the risk factors of gambling disorders in children and adolescents and was based on an analysis of foundational data from a systematic review of English-language scholarly journals over the years 2013–2021. The results of the data analysis made possible a qualitative synthesis and formulation of recommendations for parenting and preventive practice for parents and caregivers.

Food allergen introduction patterns in the first year of life: AUS nationwide survey.

Prevention guidelines have changed over the past decade and now recommend the earlier introduction of peanut and egg without delaying the introduction of other food allergens. This paper explored caregiver practices regarding the introduction of food allergens during infancy. A survey was administered (2021) to a US population-based sample of 3062 caregivers (children 7months - 3.5 years). Demographics and feeding practices were collected. Weighted frequencies and proportions were calculated using the svyr package in R 4.1. Survey-weighted chi-square statistics and covariate-adjusted, survey-weighted logistic regression models were used for statistical inference. Cow's milk, wheat, and soy were the top three allergens introduced. Peanut and egg were introduced by 17.2% and 15.5% of caregivers before 7months and 58.8% and 66.4% before 1year, respectively. The age of peanut and egg introduction differed significantly by race/ethnicity (p < .001) and caregiver age (p < .001). Peanut and egg introduction before 7months was significantly associated with the increased introduction of other allergenic foods before 1year (p=<.001; peanut and p=< .001; egg). Caregivers who introduced peanut and egg before 7months infant age fed an additional mean of 5.4 and 4.5 food allergens, respectively, before 1year. Few caregivers (0.9%) reported feeding an "early food allergen introduction product" ≥ 3 times, which was significantly associated with parental food allergy (OR=2.2) and previously seen an allergist (OR=6.7). More than half of the caregivers are not introducing peanut by age of one year and one-third are not introducing egg, though an observed shift toward earlier peanut and egg introduction was seen in the past 5 years. Peanut and egg introduction seem to co-occur and are associated with increased intake of other food allergens.

Practice of Supporting Family Caregivers of Patients with Life-Threatening Diseases: A Two-phase Study Among Healthcare Professionals.

Background: Although support for family caregivers is an essential component of palliative care, routine provision of such support is often lacking. To improve support for family caregivers, we assessed current practice and influencing factors as perceived by healthcare professionals. Methods: A two-phase study was conducted including a survey exploring healthcare professionals' practice of supporting family caregivers in Western urbanized Netherlands in 2017, and focus groups exploring facilitators and barriers to supporting family caregivers in 2018. Focus group data were thematically analyzed with deductive coding based on the COM-B system. Results: Of the 379 survey respondents (response 11%), 374 were eligible (physicians, 28%; nurses, 64%; nurse assistants, 9%). The respondents practiced in academic hospitals (52%), general hospitals (31%), nursing homes (11%) and hospices (5%). They reported to always (38%), most of the time (37%), sometimes (21%) or never (5%) provide support to family caregivers during the illness trajectory. Respondents reported to always (28%), sometimes (39%), or never (33%) provide support after death. Four focus group discussions with 22 healthcare professionals elicited motivational facilitators and barriers to supporting family caregivers (e.g., relationship with family caregivers, deriving satisfaction from supporting them), and factors related to capability (e.g., (lacking) conversational skills, knowledge) and opportunity (e.g., (un)availability of protocols and time). Conclusions: Support for family caregivers, especially after the patient's death, is not systematically integrated in working procedures of healthcare professionals. The barriers and facilitators identified in this study can inform the development of an intervention aiming to enhance support for family caregivers.

Home-based care of stroke patients in rural Zimbabwe: Knowledge of caregivers

ObjectivesTo describe and explore the knowledge and practices of primary caregivers and information they get from village health workers on infection prevention and control among home-based stroke patients. Materials and methodsA descriptive and exploratory study was conducted on 200 primary caregivers and 200 village health workers selected using multistage random sampling method. Data were collected using questionnaires. Visual Basic for Applications package analysed the data and analysis of variance examined differences between demographic characteristics of participants. Chi-square test was used to determine whether the socio-demographic information and adequacy of information given were associated. Statistical significance was set at p < 0.05. ResultsPrimary caregivers were not well informed of the measures to prevent chest infections and urinary tract infections as they rated themselves poor or very poor in practising these measures. There was a correlation between knowledge of prevention and control of infection to primary caregivers’ level of education (chi-square=7.49; p=0.024), and residence (chi-square=72.33; p=0.001). There was an association between information given by village health workers on rated adequacy of information and information given on: chest infections (chi-square=20.65; p < 0.0005), skin infections (chi-square=13.42; p=0.009) and urinary tract infections (chi-square=19.20; p=0.001). The information given by village health workers to primary caregivers was also associated with residence (chi-square=107.15; p < 0.0005). ConclusionOverall, primary caregivers had limited knowledge of infections in home-based stroke patients while the village health caregivers seldom gave them the necessary information. With the necessary training home-based care of stroke patient in Zimbabwe may improve.

Renegotiating Roles as Fathers and Workers: Exploring the Experiences of Migrant and Refugee Men in Australia

Migrants represent a significant and growing proportion of Australia’s population. While there has been a surge of academic literature about the experiences of migrant women, and families more generally, less attention has been given to migrant men and their roles as fathers. As fathers have a significant impact upon their children and families’ wellbeing, it is important to understand the factors influencing their wellbeing and caregiving practices within their family units. To better understand the factors contributing to migrant men’s fathering experiences and wellbeing, the authors undertook semi-structured, in-depth interviews and one focus group discussion with 10 migrant and refugee fathers living in Darwin, Australia. We define migrant fathers as those who were born outside of Australia and had children. This exploratory study aims to explore the challenges the fathers faced securing stable employment, providing caregiving, and renegotiating their identities as fathers and workers in a new country and culture. The findings demonstrate that demographic characteristics (such as education and language), structural constraints (such as access to childcare and flexible work), and cultural expectations (such as being the breadwinner and provider) defined the way many of the fathers experienced and rationalised their role as workers and fathers. These findings confirm the importance of employment in promoting and sustaining migrant and refugee men’s wellbeing as they resettle with their families. We offer a preliminary sketch for policy makers and service providers to support migrant and refugee men’s roles and identities as fathers and workers in Australia.

Complicity Consciousness: The Dual Practice of Ethnography and Clinical Caregiving in Carceral Settings.

Anthropologist-clinicians who engage in both ethnographic inquiry and clinical practice confront methodological, ethical, and epistemological predicaments that can challenge and enhance the moral practice and ethics of care inherent both to healing and to ethnography. Clinician-ethnographers often find themselves practicing within harmful systems that they also critique, such as hospitals or carceral institutions. This paper analyzes the dual practice of obstetrical care and ethnography in a county jail and a county hospital. These intertwined roles involve wrestling with sometimes conflicting vocational and ethical obligations to heal, to protect privacy, to address bodily consequences of systemic oppressions, and to critique the systems that mete human suffering. Developing a consciousness of clinical-ethnographers' complicity, rather than disavowing it, can be aligned with approaches of abolition medicine to reimagine more just forms of healing.

Female caregivers’ contextual complexities and familial power structures within Alzheimer’s care

In 2021, 11.3 million unpaid caregivers of persons with Alzheimer’s disease/Alzheimer’s disease and related dementias (AD/ADRD) provided 16 billion hours of unpaid caregiving worth $271.6 billion. This study aimed to fully capture the contextual complexities of the caregiving role acquisition articulated by female family caregivers of those with AD/ADRD, emphasizing assigned meaning to one’s lived experience with a critical focus on how family power structures influence caregiving practices. Recorded open structured interview transcripts (N = 30) from two qualitative studies with the same two opening questions resulted in a corpus of 481 pages of pooled textual data. The data were analyzed using Utrecht’s descriptive and interpretive thematic analysis approach. The interpretive thematic analysis uncovered the theme of intervening to protect and its subthemes of financial exploitation, mistreatment, and endangerment. Based on the evolving analysis, we reanalyzed the data using critical discourse analysis (CDA), drawing from Foucault and feminist CDA to explore the complex but subtle nuances of gender, power, and ideologies. CDA uncovered the theme of compulsory altruism. Ambiguity about violating personhood delayed responses to potentially dangerous behavior and actual harm. Using interpretive thematic and critical discourse analysis, we discovered a deeper understanding of female caregivers’ contextual complexities, their journey to becoming a caregiver of a family member with AD/ADRD, and the power structures that relegated caregiving to female family members. This research identified a substantial policy gap in supporting female family caregivers who provide the majority of care to persons with AD/ADRD risking their health and financial security.

The knowledge and practices of caregivers regarding the administration of oral liquid medication to children at a healthcare clinic in Bloemfontein, South Africa

Background. Children are dependent on their caregivers to accurately administer medication to them.Objectives. To determine the knowledge and practices of primary caregivers regarding their methods of oral liquid medication administration, preferred measuring utensils, accuracy of preferred measuring utensils and different medication classifications that they collected. The study was conducted at Pelonomi Polyclinic Pharmacy, Bloemfontein, South Africa.Methods. A quantitative, cross-sectional descriptive study (with analytical aspects) was conducted, which used consecutive, convenient sampling. The pharmacy staff assisted in recruiting participants, after which a screening form was used to determine their eligibility. Participants were provided with an information document and consent form. The liquid medication was classified according to a drug classification list, and one medication was selected for the focus of the structured interview. The questionnaire was completed using REDCap. Thereafter, researchers used the information on the medication label to determine the accuracy of the caregiver’s answers.Results. The majority of the 89 participants (56.2%) answered all 3 administration-related questions correctly, with 84.3% answering the questions regarding quantity and frequency correctly. The medication measure (43.8%) was the preferred measuring utensil for any liquid medication at home, and the syringe (53.9%) for the selected liquid medication used in the interview, both accurate measuring utensils. Most children (56.2%) were prescribed ‘other medication’ (e.g. vitamins and mineral supplements), followed by analgesics (47.2%) and antibiotics (42.7%).Conclusion. Primary caregivers at Pelonomi Polyclinic Pharmacy know how to administer oral liquid medication to children accurately. Most caregivers indicated that they use accurate measuring utensils

Impacts of the beginning education: early childcare at home (BEECH) program for family child care providers and young children

This study evaluated the effectiveness of the Beginning Education: Early Childcare at Home (BEECH) intervention for family childcare providers and young children (infants, toddlers, and preschoolers). BEECH emphasizes the use of responsive caregiving practices that can be embedded in daily routines and interactions. Family child care providers (n = 154) were randomized to one of 3 conditions: BEECH (n = 54), BEECH+ (n = 45), or control (n = 55). Providers assigned to the BEECH and BEECH+ conditions received access to an online course and they attended in-person trainings; BEECH+ providers received additional coaching support. Approximately 5 children per family child care provider were included in the study, resulting in a total of 643 children (157 infants, 258 toddlers, and 228 preschoolers). Results showed that family child care providers who participated in the BEECH intervention (regardless of condition) showed significant improvements on the Teacher Behaviors Rating Scale's total score, classroom sensitivity, and oral language use domains relative to the control group. BEECH and BEECH+ groups demonstrated similar improvements in provider-level outcomes, suggesting few to no differences between the two instantiations. Finally, there were limited significant differences in child outcomes between the intervention and control groups.