Type Of Primary Caregiver Research Articles

Illness perceptions in relation to self-management behaviour among elderly patients with COPD: A cross-sectional study.

The purpose of this study was to investigate the status of self-management behaviour and illness perceptions and to examine illness perceptions in relation to self-management behaviour in elderly patients with chronic obstructive pulmonary disease (COPD). A cross-sectional study was conducted, and 152 elderly COPD patients were recruited via the convenience sampling method. The COPD Self-Management Scale and the Revised Illness Perception Questionnaire for COPD patients were used to examine self-management behaviour and illness perceptions. Pearson correlation analysis, univariate analysis and hierarchical linear regression analysis were used to explore illness perceptions in relation to self-management behaviour. The mean overall score for self-management behaviour was 2.90 ± 0.39. Among the subscales of self-management behaviour, information management had the lowest score of 2.20 ± 0.76. Patients' demographic and clinical characteristics, including educational level, smoking status, type of primary caregiver, home oxygen therapy and COPD duration, were found to be significant determinants of self-management behaviour. After controlling for these variables, several illness perception subscales, including treatment control, personal control, coherence, timeline cyclical and identity, were significantly correlated with self-management behaviour. This study confirmed that elderly COPD patients' self-management behaviour was unsatisfactory and that illness perceptions were significant determinants of self-management behaviour. The findings may contribute to the development of self-management interventions for elderly COPD patients.

Trajectory patterns and influencing factors of supportive care needs in Chinese elderly breast cancer patients.

The aim of this study was to identify the trajectory patterns of supportive care needs in Chinese older patients with breast cancer and their predictive factors. A total of 122 older patients with breast cancer were recruited. Demographic and disease-related information, type D personality, and supportive care needs were investigated at baseline, 3, and 6 months. Latent class growth model was used to identify the trajectory patterns of supportive care needs. Multiple logistic regression was used to determine the predictors for membership. Three trajectories with different characteristics of changing categories of supportive care needs were identified in the final analysis, named as "High needs decline group" (38.5%), "High needs sustained group" (51.6%), and "Low needs sustained group" (9.8%). Univariate analysis showed that age, education level, number of children, primary caregiver, pathological stage, surgical modality, treatment protocols, and personality traits were associated with the trajectory categories of supportive care needs of older patients with breast cancer. Multiple logistic regression showed that primary caregiver type, treatment protocols, and personality traits were influential factors in the trajectory of supportive care needs of older patients with breast cancer. Our study demonstrates the heterogeneity of changes in supportive care needs. The supportive care needs of older patients with breast cancer show a trajectory of change in different categories, and healthcare providers can develop individualized interventions based on the characteristics of different patients.

Caregiver Type and Gang Involvement: A Comparison of Female and Male Gang Members

Gang involvement and delinquency are prominent issues frequently examined in criminal justice scholarship. Research has revealed that gang involvement increases the likelihood of delinquency/crime, and that youth participate in gangs for a variety of reasons including protection, status, and a sense of belonging. Although research has found that various social and familial factors increase the probability of gang involvement, it primarily focuses on males, and little work has compared how a youth’s primary caregiver influences the likelihood of gang involvement among both male and female gang members. The current study uses school level data to examine gang involvement and primary caregiver type among male and female youth. The results identify significant differences in gang involvement among boys and girls when examining primary caretaker. The findings have implications for theory and programming in connection with youth gang involvement for both boys and girls.

Association of rurality, type of primary caregiver and place of death with end-of-life medical expenditures among the oldest-old population in China

BackgroundUnderstanding whether the type of primary caregiver and end-of-life (EOL) care location are associated with EOL medical expenditures is crucial to inform global debates on policies for efficient and effective EOL care. This study aims to assess trends in the type of primary caregiver and place of death stratified by rural‒urban status among the oldest-old population from 1998–2018 in China. A secondary objective is to determine the associations between rurality, the type of primary caregiver, place of death and EOL medical expenditures. MethodsA total of 20,149 deaths of people aged 80 years or older were derived from the Chinese Longitudinal Health Longevity Survey (CLHLS). Cochran-Armitage tests and Cuzick’s tests were used to test trends in the type of primary caregiver and place of death over time, respectively. Tobit models were used to estimate the marginal associations of rurality, type of primary caregiver, and place of death with EOL medical expenditures because CLHLS sets 100,000 Chinese yuan (approximately US$15,286) as the upper limit of the outcome variable. ResultsOf the 20,149 oldest-old people, the median age at death was 97 years old, 12,490 (weighted, 58.6%, hereafter) were female, and 8,235 lived in urban areas. From 1998–2018, the prevalence of informal caregivers significantly increased from 94.3% to 96.2%, and home death significantly increased from 86.0% to 89.5%. The proportion of people receiving help from informal caregivers significantly increased in urban decedents (16.5%) but decreased in rural decedents (-4.0%), while home death rates significantly increased among both urban (15.3%) and rural (1.8%) decedents. In the adjusted models, rural decedents spent less than urban decedents did (marginal difference [95% CI]: $-229 [$-378, $-80]). Those who died in hospitals spent more than those who died at home ($798 [$518, $1077]). No difference in medical expenditures by type of primary caregiver was observed.ConclusionsOver the past two decades, the increases in informal caregiver utilization and home deaths were unequal, leading to substantially higher EOL medical expenditures among urban decedents and deceased individuals who died at hospitals than among their counterparts who lived in rural areas and died at home.

Pre-service factors associated with sexual misconduct among male U.S. Marines.

Sexual assault is a prevalent and persistent problem in the military, yet few studies have examined predictors of sexual offenses. The study aim was to determine pre-service factors associated with sexual offense conviction among U.S. Marines. This retrospective cohort study analyzed data from male active duty U.S. Marines (2003-2018). Pre-service factors were assessed using survey data from the Recruit Assessment Program, obtained prior to recruit training at the Marine Corps Recruit Depot, San Diego, California. These survey data were linked with sexual offense conviction data obtained from the Naval Criminal Investigative Service Consolidated Law Enforcement Operations Center. Of the 146,307 participants, the majority were 18-19 years old (66.7%) and non-Hispanic, White (62.1%) with a high school education or less (76.8%); 107 received convictions for a sexual offense. In unadjusted analyses, race and ethnicity, parental education, type of primary caregiver, parental death, family economic status, childhood emotional trauma, childhood physical abuse, childhood sexual abuse, and unprotected sex were associated with a sexual offense conviction. In the final multivariable model, race and ethnicity (American Indian/Alaskan Native, odds ratio [OR]: 5.28, 95% confidence interval [CI]: 1.86-14.98; Hispanic, OR: 1.83, 95% CI: 1.06-3.18; multiracial/other, OR: 3.28, 95% CI: 1.56-6.89), education (≤ high school, OR: 2.65; 95% CI: 1.21-5.80), parental death (OR: 2.27; 95% CI: 1.16-4.45), unprotected sex (OR: 1.78; 95% CI: 1.03-3.05), and school suspension/expulsion (OR: 1.64; 95% CI: 1.02-2.65) were significant predictors of a subsequent sexual offense conviction. Results underscore the importance of understanding factors associated with sexual offense and highlight the large discrepancy between self-reported estimates of sexual assault and sexual offense convictions. Findings may inform the development of effective strategies to reduce sexual misconduct, such as technology-facilitated programs that provide private, targeted education; supportive assistance; and prevention materials to individuals who may have elevated sexual misconduct risk.

Impact of an Early Childhood Development Intervention on the Mental Health of Female Caregivers: Evidence from a Randomized Controlled Trial.

Investing in early childhood development is an effective way to enhance human capital accumulation. Caregivers’ mental health is one of the most important factors influencing children’s development. Previous studies have found that mental health issues in caregivers are widespread all over the world, especially in low- and middle-income countries. In this study, we explored the effects of the “Integrated Program for Early Childhood Development” on the mental health of female caregivers in Southwest China through a randomized intervention trial, with infants aged 5–25 months and their caregivers as the target subjects. The heterogeneity of the effects of different characteristics of the caregivers and the mechanism of the intervention effect were also analyzed. Primary caregivers were provided comprehensive early development interventions for the children in the treatment group via bi-weekly home visiting activities and monthly family group activities. The results showed that the prevalence of depression, anxiety, and stress symptoms among female caregivers in this rural area were 32%, 42%, and 30%, respectively. Whether the child was breastfed, parent’s age, parent’s education level, primary caregiver type, the ratio of the number of months the mother was at home full time to the child’s age, the grandmother’s rearing ability, and the family asset index were the factors influencing the mental health of female caregivers. The intervention significantly increased the proportion of depressive symptoms in 28% of the grandmothers. It significantly reduced the anxiety symptoms of daughters-in-law not from the local town, while the social interactions of both local and non-local daughters-in-law were significantly improved.

Examining Characteristics and Service Utilization of South Korean Home Health Care Patients: Secondary Analysis of 10-Year Data From a Tertiary Hospital

This study aimed to identify the characteristics of home health care (HHC) patients, main diagnoses, service type, home visit patterns, and primary caregiver type from a major tertiary hospital in South Korea to provide basic data for tailored nursing care. We used Electronic Health Records (EHRs) data of 1776 patients, from 2011 to 2020, from a premier tertiary hospital in South Korea and conducted secondary data analysis using descriptive statistics, a chi-squared test, and an independent samples t-test. Patients’ mean age (i.e., 50.9% men and 49.1% women) was 74.50 ± 15.48 years. Further, admission to HHC via the outpatient and inpatient department comprised 1047 (59.0%) and 729 patients (41.0%), respectively. Based on the Korean Standard Classification of Diseases, neoplasms (49.9%) were identified as the most common main diagnosis, followed by diseases of the nervous system (10.3%) and musculoskeletal system and connective tissue disease (6.2%). An average of 2.2 homecare nursing services were provided per visit, with lab sampling (43.9%), other intravenous injections (31.0%), and ventilator care (23.0%) being the most frequent services. The total HHC service period for patients via the outpatient department was 76.88 days longer (292.24 vs 215.36 days) than those from the inpatient department. Younger patients were cared for by parents and siblings and older patients by spouses, offspring, and formal caregivers. It is pivotal to identify general characteristics of HHC patients through long-term monitoring and retrospective analysis to provide high-quality and tailored interventions to them.

Association between primary caregiver type and mortality among Chinese older adults with disability: a prospective cohort study

BackgroundSocio-demographic transitions have dramatically changed the traditional family care settings in China, caused unmet care needs among older adults. However, whether different primary caregiver types have different influences on disabled older adults’ health outcomes remain poorly understood. We aimed to examine the association between the type of primary caregiver (e.g., spouse and children) and death among community-dwelling Chinese older adults disabled in activities of daily living.MethodsWe used data from Chinese Longitudinal Healthy Longevity Survey. The analytic sample comprised 4278 eligible adults aged ≥ 80 years. We classified primary caregiver type into five categories: spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and domestic helper. We used Cox regression model to examine the association between primary caregiver type and all-cause mortality. Covariates included age, sex, residence, years of education, co-residence status, financial independence, whether living with children, number of ADL disability, number of chronic conditions, and self-reported health, cognitive impairment, and caregiving quality.ResultsMarried older adults whose primary caregivers were son/daughter-in-law had a 38% higher hazard of death than those who had spouse as the primary caregiver. Married men who received care primarily from son/daughter-in-law or daughter/son-in-law had a 64 and 68% higher hazard of death, respectively, than those whose primary caregiver was spouse. The association between primary caregiver type and mortality among widowed older adults differed between urban and rural areas. Urban residents who had domestic helpers as the primary caregiver had an 16% lower hazard of death, while those living in rural areas had a 50% higher hazard of death, than those having son/daughter-in-law as the primary caregiver.ConclusionsThe quality of care of the primary caregiver may be a risk factor for mortality of disabled older adults in China. Interventions are necessary for reducing unmet needs and managing care burden.

CAREGIVER TYPE AND ITS ASSOCIATION WITH MORTALITY AMONG OLDER ADULTS WITH DISABILITY IN CHINA

A large proportion of older adults in China needs assistance with activities of daily living (ADL). The quality of care for this population has gained growing attention. However, little is known about the patterns of their caregiver type or its association with mortality. We examined the patterns of primary caregiver type among community-dwelling older adults in China and to examine the association between caregiver type and mortality. Data were from the 2005, 2008, and 2011 waves of the China Longitudinal Health and Longevity Study. We included 437 married and 3,971 widowed participants. The average age was 96.7 years (SD=6.9) and 73.7% were female. For married persons, 55.1%, 25.2%, 12.1%, 2.3%, and 3.9% of the primary caregiver was spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper. For widowed persons, 60.2%, 21.1%, 9.9%, and 5.9% of the primary caregiver was son/daughter-in-law, daughter/son-in-law, grandchildren, and housekeeper, respectively. Multivariable-adjusted model showed that, among married older adults, son/daughter-in-law and daughter/son-in-law as the primary caregiver was associated with 41% (95% confidence interval [CI]=6%-87%) and 67% (95%CI=10%-154%) higher mortality than spouse as the primary caregiver, respectively. For widowed persons, daughter/son-in-law and grandchildren as the primary caregiver was associated with 12% (95%CI=3%-20%) and 14% (95%CI=2%-24%) lower mortality than son/daughter-in-law as the primary caregiver, respectively. Majority of disabled older adults in China relied on their spouse and children to care for them. Type of primary caregiver was associated with death in both married and widowed persons. More resources need to be allocated to disabled Chinese older adults with poor survival outcomes.

Type of caregiver and its association with mortality among adults aged 65 years and older who require assistance with activities of daily living in China: a longitudinal study

BackgroundA large proportion of older adults (age 65 years and older) in China need assistance with activities of daily living. The quality of care for this population has attracted growing attention. However, little is known about the patterns of their caregiver type or its association with mortality rates. We examined the pattern of primary caregiver type among community-dwelling older adults in China, and the association between caregiver type and mortality. MethodsData were from the China Longitudinal Health and Longevity Study (an ongoing survey conducted in 22 provinces) from 2005, 2008, and 2011. We described the relative frequency of caregiver type among married and widowed adults aged 65 years and older. Cox models were used to examine the association of primary caregiver type with mortality. The research ethics committees of Peking University and Duke University granted approval for the protection of human subjects for the China Longitudinal Health and Longevity Study. All study participants gave informed written consent. FindingsWe included 437 married and 3971 widowed participants. The average age was 96·7 (SD 6·9) years and 73·7% (3332 of 4408) were female. For married people, the primary caregiver was the spouse (55·1%, 241 of 437), son and daughter-in-law (25·2%, 110 of 437), daughter and son-in-law (12·1%, 53 of 437), grandchild (2·3%, 10 of 437), or housekeeper (3·9%, 17 of 437). For widowed people, the primary caregiver was the son and daughter-in-law (60·2%, 2462 of 3971), daughter and son-in-law (21·1%, 864 of 3971), grandchild (9·9%, 403 of 3971), or housekeeper (5·9%, 242 of 3971). A multivariable adjusted model (a regression model with one outcome and adjusting for multiple variables) showed that among married adults aged 65 years and older, hazard of death was higher when the primary caregiver was a son and daughter-in-law (41% [95% CI 6–87]) or daughter and son-in-law (67% [10–154]) than when the spouse was the primary caregiver. For widowed people, hazard of death was lower when the primary caregiver was a daughter and son-in-law (12% [3–20]) or a grandchild (14% [2–24]) than when a son and daughter-in-law was the primary caregiver. InterpretationThe majority of adults aged 65 years and older who need assistance with activities of daily living in China relied on their spouse and children to care for them. The type of primary caregiver was associated with mortality rate in both married and widowed people. More resources should be allocated to such older Chinese adults who have poor survival outcomes. FundingNone.

“Who cares” is key: factors associated with oral health status in children living with HIV in Phnom Penh, Cambodia

ABSTRACTThis cross-sectional study aimed to identify social, clinical, and behavioral factors associated with the oral health status of children living with HIV in Phnom Penh, focusing particularly on the effect of primary caregiver type. Data were collected through separate interviews with children and caregivers. The decayed, missing, filled permanent teeth (DMFT) index and debris index scores were assessed for each child. Associations between oral health status and caregiver type as well as with other factors were examined using multiple linear regression. Of 142 total dyads (mean child and caregiver age, 12.3 (SD 1.8) and 44.8 (SD 10.6) years, respectively) 48.6% and 29.6% of caregivers were biological parents and institutional staff, respectively. Children with institutional staff as a primary caregiver had a lower DMFT score (2.81 vs. 5.50), higher rate of ever visiting a dentist (90.5% vs. 50.7%), and better oral health status than those cared for by biological parents. Higher DMFT score was negatively associated with institutional staff as primary caregiver (β: −1.642, 95% CI: −2.925, −0.360) and positively associated with longer antiretroviral therapy period (β: 0.223, 95% CI: 0.056, 0.390). Targeted oral health care programs are needed for children living with HIV whose biological parents are their primary caregivers.

Factors Related to the Institutionalization of Older Aged Individuals Using Home- and Community-Based Care Services: Data From the South Korea Long-Term Care Insurance Program, 2008–2013

ABSTRACTSouth Korea introduced a public long-term care insurance (LTCI) program in response to its rapidly aging population. This study analyzed the association between living arrangement and caregiver type with institutionalization in LTCI grade 1 (very severe limitations), 2 (severe limitations), and 3 (moderate limitations) beneficiaries using data from the LTCI cohort, 2008 to 2013. The dependent variable was alteration status from home to institutional care within 1 year of receiving home service. Independent variables were living arrangement and primary caregiver type. The analysis was conducted using the generalized estimating equation model. Higher likelihoods of institutionalization were found in individuals living with a non-family member compared to individuals living with their spouses. Individuals without a caregiver or with a paid caregiver were also more likely to experience institutionalization than individuals with a spouse primary caregiver. Our findings underscore the importance of monitoring identified vulnerable groups of individuals to attain LTCI sustainability and enhance elderly quality of life.

Prevalence of Psychiatric Function Disorders in Psychogeriatric Patients at Referral to Nursing Home Care – the Relation to Cognition, Activities of Daily Living and General Details

Objectives: This prospective, observation study (from June 2001 to October 2002) estimated the prevalence and co-occurrence of psychiatric function disorders (PFDs) in psychogeriatric patients suffering from cognitive function disorders at referral to clinical as well as non-clinical (transmural) psychogeriatric programmes. It is expected that PFDs, both total and individual, are positively related to the cognitive function disorders as well as the activities of daily living (ADL) handicaps. This expectation will be adjusted for general details particularly gender, age, marital status, domicile and type of primary caregiver. Exploratively, the structure of the interrelationship of PFDs, cognitive function disorders and ADL handicaps will be analysed. In addition, the general details and the structure to be identified will be described. Methods: We studied patients aged ≧ 65 years (n = 487), who were suspected to suffer from cognitive function disorders (MMSE ≤ 29) and were referred to trans-/intramural nursing home care in the Nieuwe Waterweg Noord region. General details, i.e. gender, age, marital status, domicile, primary caregiver, as well as PFDs (the Neuropsychiatric Inventory, NPI), cognition (MMSE) and ADL (Barthel Index, BI) were assessed. Results: Mean score NPI was 3.6 (SD = 2.3). Of the patients, 91.7% scored one or more NPI symptom; 81.6% two or more. Depression (43.9%), apathy (43.1%), anxiety (41.6%) and agitation/agression (31.2%) had a high prevalence. With respect to the NPI symptoms, i.e. delusion, hallucination, anxiety (more in women), agitation/aggression and irritability (more in men), there were significant gender differences on the same MMSE level. Compared with women, men were significantly younger, ADL independent, lived together with their spouse, who was often the primary caregiver. The performance of the logistic regression models for total NPI score with MMSE, BI separately as well as combined with general details was minor. The results of the regression analyses for the individual NPI symptoms showed comparable low R² values; they explained a small proportion of the variance. However, in the PRINCALS analysis the MMSE and BI highly correlated with the cognitive dimension, and the NPI with the psychiatric dimension. The model fit was good; 82.6% of the variance was explained. Conclusion: At the moment of referral to nursing home care, the prevalence and co-occurence of PFDs was high. The four main NPI symptoms were depression, apathy, anxiety and agitation/aggression. On the same level of MMSE score, gender difference was important for 3 NPI symptoms: delusion, hallucination and anxiety. NPI scores (total and per symptom) were relatively independent from MMSE, BI and general details. The PFDs – measured by the NPI – were a dimension on their own. Therefore, in psychogeriatrics it is of clinical relevance to think and act in terms of dimensions. Irrespective of a more rational psychopharmaceutical regime, this opens the door to the regular psychiatric domain for (psycho)therapeutic strategies, e.g. for depression and anxiety adapted to the kind and level of the cognitive function disorder of the psychogeriatric patient.