Prospective Caregivers Research Articles

Exploration of meaning, motivation, and preparedness to care amongst the one-child policy generation in China.

In China there is a cultural expectation (Xiao, -filial piety) that offspring should provide care for their parents. However, the sustainability of this is threatened by the impact of the One-Child Policy (OCP) (1979-2015), which has resulted in a diminution in numbers of children available to care, rapid urbanisation and increase in the number of women in employment. In this context, the objective was to explore the motivations, meaning, and preparedness for future caregiving of offspring affected by the OCP. We adopted a constructivist position using a hermeneutic phenomenology approach and interviewed eight current and prospective caregivers aged 20-35years about future caregiving responsibilities. Data were obtained through in-depth interviews, analysed using reflective Thematic Analysis. Three prominent themes: (i) Caregiving beliefs, (ii) Caregiving conditions and (iii) Contextual factors were identified under an overarching theme "Competing pressures-meanings, motivation and preparedness". Despite the inherent stress, participants envisaged providing or organising care in the future to fulfil Xiao, and most viewed long-term care settings as unviable. Ultimately, the findings suggested that the actual performance of caregiving would not always measure up to ideal expectations, resulting in 'filial discrepancy' that is, a gap between societal expectations for caregiving to older relatives and actual caregiving performance. This could adversely impact the caregivers and quality of care provided. The findings highlighted the urgent need to develop culturally attuned services, including education and training for family caregivers, health and social care professionals.

Caregiver Segmentation Using The Integration of The Modified Burden Dimensions and Fuzzy C-Means

The increasing demand for Indonesian female caregivers to Taiwan, raises issues related to caregiver burden. In this study, a segmentation analysis of 299 questionnaire data that consisted of Zarit Burden Interview (ZBI) instrument and four dimensions: personal strain, role strain, dependency, and guilt (PRDG) was conducted to find selection pattern strategies of prospective caregivers based on their characteristics. The results of confirmatory factor analysis (CFA) indicated the need to add “social life” as a new dimension (S+PRDG) representing the caregivers’ social problems, while the results of multiple regression analysis indicated three most influential characteristics of a caregiver: number of children, education level, and work location. The segmentation analysis was carried out using Fuzzy C-Means on the modified PRDG model which is (S+PRDG) and resulted two best segments that have a fuzzy silhouette index value of 0.61. From the analysis of these two segments, the resilient caregivers were those in the second segment with the characteristics such as having children, having level of education up to junior high school, and working in the capital city of Taiwan.

Filial Maturity and Attachment Dimensions as Predictors for Prospective Caregiving Expectations

The role of attachment and filial maturity dimensions in predicting expectations of filial caregiving was investigated on a sample of 296 (186 females) prospective caregivers aged 26 to 60. Consistent with previous studies, attachment avoidance negatively predicted the filial caregiving expectations. These effects were partially mediated by filial comprehending, which predicted higher self-expectations in providing assistance to the parent. Filial distancing was proven to be a negative predictor of caregiving expectations, although in low relation with attachment avoidance. Findings suggest the importance of further exploration, as well as the importance of the concept of filial maturity in the context of filial responsibilities and long-term parent-child relations.

Intersections between the culture ofXiao(孝) and caring for older relatives in China: perspectives of United Kingdom-based Chinese students on future care for their parents

AbstractEmphasis placed onXiao(孝; filial piety) in Chinese culture highlights parents' investment in their children with the expectation of being cared for when older. An increasing number of Chinese students come to the United Kingdom (UK) to study, with the majority returning home and likely to become future care-givers for their parents. Little attention has been paid to the implications of transnational mobility of Chinese students on the reciprocal aspects of future care responsibility. With the uniquely changing family structure due to consequences of the One-Child Policy, we conducted proactive research on the opportunities and challenges that Chinese transnational students anticipate they may face in future care-giving for elderly parents. Hence, this study's aim was to make a novel contribution to knowledge through exploration of the perspectives of Chinese students in England on intergenerational ties and filial obligations. Adopting a social constructivist philosophical position, we conducted three focus groups with 19 UK-based Chinese students, using a semi-structured topic guide with informed consent. Interviews were translated, transcribed and analysed using reflective thematic analysis, capturing semantic and latent meanings, and employed a descriptive and interpretative approach. Six themes were discovered, revealing a ‘culture of duty’ where familial obligation and societal expectations were prominent. Prospective care-givers anticipated a future dilemma between balancing work commitments and providing care as mandated byXiao. Furthermore, it appeared that lack of preparedness might further exacerbate barriers faced when accessing support. We surmised that the changing demographics and absence of formal support could compound stressors over time, especially if cognitive dissonance arises as realities of life do not fit with societal expectations. Our findings imply that policy makers, practitioners and the government will need to adequately support prospective family care-givers who are returnees in caring for older generations.

Modified PRDG Model for Caregiver Segmentation Using Zarit Burden Interview Instrument

The increasing demand for Indonesian workers in Taiwan has an impact on caregiver problems which can be triggered by the burden of caring for the elderly. Therefore, the aim of this study is to identify the characteristics of caregivers who are resilient to burdens based on Indonesian female caregivers who work in Taiwan data to be a guide for selecting prospective caregivers. The process includes analyzing the personal characteristics that have the most influence on the burden using multiple regression and then clustering caregiver data using K-Means with the Elbow Method and Silhouette Index. Then, segmentation in each cluster based on a comparison of the average values. The results of clustering accuracy on dimensions (PRDG) and modified dimensions (S+PRDG) were compared and the smallest error cluster was in case 4 in the S+PRDG dimension with the Elbow Method of 3.6%. Based on segmentation on that dimension, cluster 2 is a resilient caregiver cluster. Then the results of the multiple regression analysis (Number of Children, Education and Work Location) were studied further for each caregiver in cluster 2 and the conclusions are, their average number of children is 1, final education is in junior high school and their work location is in the capital of Taiwan.

The relationship between personality traits, caring characteristics and abuse tendency among professional caregivers of older people with dementia in long-term care facilities.

To explore the relationship between personality traits, caring characteristics and abuse tendency among professional caregivers of older people with dementia in long-term care facilities in China. Elder abuse is a serious global health problem and human right violation with high incidence among older people with dementia. There are many investigations about impact factors of risk of abuse among family caregivers of older people with dementia. However, in long-term care facilities, the situation of abuse tendency needs further investigation. Cross-sectional study. An observational survey was conducted according to the STROBE checklist. We investigated 156 professional caregivers of older people with dementia in three long-term care facilities in Guangzhou, China. Participants completed a demographic questionnaire, the Caregiver Abuse Screen (CASE) and the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). Data were analysed using Mann-Whitney U tests, Kruskal-Wallis tests, Spearman's rank correlation and logistic regression analyses. Over half of the participants (51.9%) reported abuse tendency to the older people with dementia. There was a significant negative correlation between the caregivers' agreeableness scores of NEO-FFI and their CASE scores. Multivariate logistic regression analyses highlighted that protective factors of abuse tendency were caregivers' agreeableness, care recipients' source of finances and their duration of dementia while higher care difficulty and presence of older people's behavioural and psychological symptoms of dementia (BPSD) were the risk factors. Caregivers' agreeableness personality trait and the caring characteristics of older people with dementia may be relevant to abuse tendency in long-term care facilities. Further study with a larger sample size is needed to validate such a correlation. Older people with dementia are at high risk for abuse. Prospective caregivers could pay more attention to developing their own agreeableness. The managers might establish monitoring system for reducing the abuse.

Palliative Care in SMA Type 1: A Prospective Multicenter French Study Based on Parents' Reports

Spinal muscular atrophy type 1 (SMA-1) is a severe neurodegenerative disorder, which in the absence of curative treatment, leads to death before 1 year of age in most cases. Caring for these short-lived and severely impaired infants requires palliative management. New drugs (nusinersen) have recently been developed that may modify SMA-1 natural history and thus raise ethical concerns about the appropriate level of care for patients. The national Hospital Clinical Research Program (PHRC) called “Assessment of clinical practices of palliative care in children with Spinal Muscular Atrophy Type 1 (SMA-1)” was a multicenter prospective study conducted in France between 2012 and 2016 to report palliative practices in SMA-1 in real life through prospective caregivers' reports about their infants' management. Thirty-nine patients were included in the prospective PHRC (17 centers). We also studied retrospective data regarding management of 43 other SMA-1 patients (18 centers) over the same period, including seven treated with nusinersen, in comparison with historical data from 222 patients previously published over two periods of 10 years (1989–2009). In the latest period studied, median age at diagnosis was 3 months [0.6–10.4]. Seventy-seven patients died at a median 6 months of age[1–27]: 32% at home and 8% in an intensive care unit. Eighty-five percent of patients received enteral nutrition, some through a gastrostomy (6%). Sixteen percent had a non-invasive ventilation (NIV). Seventy-seven percent received sedative treatment at the time of death. Over time, palliative management occurred more frequently at home with increased levels of technical supportive care (enteral nutrition, oxygenotherapy, and analgesic and sedative treatments). No statistical difference was found between the prospective and retrospective patients for the last period. However, significant differences were found between patients treated with nusinersen vs. those untreated. Our data confirm that palliative care is essential in management of SMA-1 patients and that parents are extensively involved in everyday patient care. Our data suggest that nusinersen treatment was accompanied by significantly more invasive supportive care, indicating that a re-examination of standard clinical practices should explicitly consider what treatment pathways are in infants' and caregivers' best interest. This study was registered on clinicaltrials.gov under the reference NCT01862042 (https://clinicaltrials.gov/ct2/show/study/NCT01862042?cond=SMA1&rank=8).

Social work’s fingerprint on the evolution of attachment theory: Some essential knowledge for care practice

INTRODUCTION: Social work practice knowledge was seminal to the evolution of attachment theory. This disciplinary connection is little known to many social work practitioners. This article seeks to remind care practice social workers specifically of this association, as the social work skills upon which early attachment knowledge was premised remain important to contemporary care practice.METHOD: Through a three-part discussion, this article aims to deepen care practice social workers’ understanding of attachment theory and its practical relevance for care practice assessment. The first section outlines the watershed moments of the theory’s development. The second highlights social work’s connection to this development. The third and final section reviews the construct of the internal working model and its value for distinguishing emotional differences in an adult’s relational biography.FINDINGS AND IMPLICATIONS: A key care practice goal is to facilitate the healthy growth and development of children and young people who have been placed in foster care due to maltreatment. A growing number of attachment researchers have found that the internal working model of a child’s new caregivers, with respect to attachment, is an important element in the revision of the child’s internal working model of relationships (Pace & Zavattini, 2011). Thus, care practice social workers need to pay close attention to relational facets in prospective caregivers’ assessments as some literature suggests that practitioners struggle to understand the role attachment orientation plays in the care relationship (Bick & Dozier, 2008).CONCLUSIONS: This article highlights and elaborates upon the utility of attachment theory for present-day care practice and argues that a deep understanding of this theory is likely to be instrumental to achieving better relational outcomes in foster care. This knowledge is foundational to conceptualising the different relational expectancies that prospective foster parents might bring to a new relationship.

When Employment and Caregiving Collide: Predictors of Labor Force Participation in Prospective and Current Caregivers

ABSTRACTObjective: Female caregivers often reduce time spent at work to care for aging family members, which precipitates financial hardship and other adverse outcomes. Little is known about psychosocial correlates of labor force participation (LFP) among female caregivers. The theory of planned behavior posits that social norms, attitudes, and perceived control predict intentions and volitional behaviors, but also that the compelling influence of situational variables undermines enactment of behaviors consistent with one’s intentions. The objective of this study was to employ the theory of planned behavior to examine how psychosocial characteristics predict willingness to reduce LFP among prospective caregivers and actual LFP reduction among active caregivers. Methods: Subsamples of 165 female prospective caregivers and 97 active female caregivers responded to a survey assessing filial beliefs and LFP. Results: Filial obligation and caregiver preparedness predicted intentions to reduce LFP among prospective caregivers, but did not predict actual reduction in LFP in active caregivers. Weekly care demands exceeding 20 hours emerged as the sole correlate of LFP among active caregivers. Conclusions: Domains of the theory of planned behavior predict LFP intentions, but LFP decisions are subject to external pressures, specifically, time demands of the caregiving relationship. Prospective caregivers may benefit from proactive interventions aimed at reducing conflict between situational demands and filial beliefs.

Prepared to care: adult attachment and filial obligation

Objectives: Past work found that close adult attachment dimension scores predict caregiver preparedness. Theory and past research suggests filial obligation (FO) may mediate the relationship between attachment and caregiver preparedness. The goal of this study was to test that hypothesis.Method: The sample, collected using Mechanical Turk, included 165 women between the ages of 45 and 65 years who were not providing care to an aging parent. Participants were reimbursed $0.75 for completing an online survey assessing response validity, dimensions of adult attachment, depressive symptomatology, FO, and caregiver preparedness, among other variables. The mean participant age was 52.2 years (SD = 5.5).Results: The sample was predominantly White/Caucasian (82.6%), and Black/African American (7.3%). With respect to education, 14.5% completed high school or general education development (GED), 32.7% completed some college, 36.4% completed a Bachelor's degree, and 15.7% completed graduate degrees. The three attachment dimensions (close, dependent, and anxious) and FO were all significantly inner-correlated. Stepwise multiple regression analyses found that FO fully mediates the relationship between close attachment and caregiver preparedness, even after controlling for age, education, income, depression, and birth order.Conclusion: The primary finding is that FO mediates the relationship between close attachment style and caregiver preparedness among prospective caregivers. This suggests that individual differences in attachment style among prospective caregivers indirectly predict preparedness for future caregiving through FO, suggesting a mechanism relating attachment style and preparation for future care.

Poster 1 An Evaluation of the Health, Perceived Needs, and Characteristics of Prospective Caregivers During Inpatient Brain Injury Rehabilitation

PM&RVolume 3, Issue 10S1 p. S175-S175 2011 AAPM&R Annual Assembly Abstract Poster 1 An Evaluation of the Health, Perceived Needs, and Characteristics of Prospective Caregivers During Inpatient Brain Injury Rehabilitation Jennifer A. Cohn MD, Jennifer A. Cohn MD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorSteven Barncord PhD, Steven Barncord PhD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorThao T. Duong MD, Thao T. Duong MD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorStephanie A. Kolakowsky-Hayner PhD, CBIST, Stephanie A. Kolakowsky-Hayner PhD, CBIST Stanford, San Francisco, CA, United StatesSearch for more papers by this authorLinh Nguyen, Linh Nguyen Stanford, San Francisco, CA, United StatesSearch for more papers by this author Jennifer A. Cohn MD, Jennifer A. Cohn MD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorSteven Barncord PhD, Steven Barncord PhD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorThao T. Duong MD, Thao T. Duong MD Stanford, San Francisco, CA, United StatesSearch for more papers by this authorStephanie A. Kolakowsky-Hayner PhD, CBIST, Stephanie A. Kolakowsky-Hayner PhD, CBIST Stanford, San Francisco, CA, United StatesSearch for more papers by this authorLinh Nguyen, Linh Nguyen Stanford, San Francisco, CA, United StatesSearch for more papers by this author First published: 22 October 2011 https://doi.org/10.1016/j.pmrj.2011.08.055Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume3, Issue10S1September 2011Pages S175-S175 RelatedInformation

Guardianship of orphans and vulnerable children. A survey of current and prospective South African caregivers

Increasing numbers of orphaned and vulnerable children resulting from AIDS deaths requires practical placement strategies. While the extended family is regarded as both the most likely and the preferred option by most key planners and organizations, warnings of the limitations of this alternative have been increasing. This study assessed the views of 1400 adults (both current and prospective caregivers) regarding the placement of children. Most current caregivers believed that either their partner (30%), a grandparent (25%) or another family member (33%) would look after the child/children if they were no longer able to. However, 12% of parents could not identify a carer or predicted only a bleak future for their children. There was strong willingness amongst adults of various relational proximity to take in children if required to −71% of both fathers and grandparents, 63% of siblings and 23% of best friends said they would take in children. Nonetheless this research suggests that the willingness may not necessarily be translated into reality. Most prospective caregivers identified significant additional stressors (most importantly financial) and expressed a strong need for assistance if they were to take in additional children. The HIV status of the child is also likely to sway placement decisions for some people. Nonetheless opportunities to keep children in families are clearly high, but people will need considerable help to realize this potential. For some children alternatives other than the extended family will be required

First Communion: The Emergence of Vocal Relationships

Human infants engage in vocal communion with their mother and other prospective caregivers as soon as it becomes possible to do so. As the term is used here, ‘communion’ refers to a continuous state or feeling of connectedness owing to the existence of a communications link that is maintained largely by the vocalizations of infants and caregivers. It is proposed that certain types of vocalization that infants place in this channel encourage physical approach and caregiving. Several of the social behaviors that predict lexical learning, including joint attention and vocal imitation, are also, in theory, associated with maternal attachment. Since quality of attachment also predicts language development, research is needed to determine which behaviors are functionally related to language learning and which are only symptomatic of a relationship that is independently influential.

What are the educational needs of prospective family caregivers of newly disabled adults?

What are the needs of family caregivers of newly disabled adults? Research to date has focused on the needs of family members of patients in critical care units and of family members who have been in the caregiver role at home for some time. No studies could be found on the perceptions of individuals facing the decision to assume the family caregiver role for a newly disabled adult anticipating discharge from a physical rehabilitation or medical-surgical nursing unit. Watson's philosophy of science and caring provided the theoretical basis for this study. The Elaine Matthis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the perceptions of prospective family caregivers visiting newly disabled adults in an urban medical center. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to take disabled adult relatives home.