Psychological Health Of Caregivers Research Articles

Physical and Psychological Burden among Caregivers of Latinx Older Adults with Stroke and Multimorbidity.

To investigate the association between Latinx older adults' stroke, multimorbidity, and caregiver burden. For this retrospective cohort study, we used the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) Wave-7 data set. The caregiver's physical burden was defined by using the Level of Burden Index. The caregiver's psychological burden was measured by using the Perceived Stress Scale (PSS-4). Multimorbidity was defined as the presence of 3 or more chronic conditions. The average age of the Latinx adults was 86 years, and the caregivers were 56 years. Latinx older adults and caregivers were more likely to be females (66% and 75%). Most caregivers were children (71%). Twelve percent of Latinx older adults presented with stroke, and 50% presented with multimorbidity. Caregiver physical burden was stratified into 3 levels: low (43%), medium (17%), and high (40%) burden. The cumulative logit model revealed that caregivers caring for those with stroke or multimorbidity had a high physical burden. Family caregivers and caregivers with a higher household income had a low physical burden. Caregivers with multimorbidity had a higher psychological burden. Caregivers who were interviewed in Spanish and those with higher household incomes had decreased psychological burden. This study revealed that caregivers had a higher physical burden among caregivers of Latinx adults with stroke or multimorbidity. Future studies must investigate the relationship between Latinx adults' stroke and caregiver psychological health, and build culturally tailored policies and community interventions to support caregivers susceptible to high stress and burden.

Impact of Caring for Mentally Ill Patient on Caregivers

Mentally ill person needs caretakers during hospitalization for severe conditions, continuing care, and rehabilitation. Caretakers experience mental illness when providing care for their mentally ill patients in Nepal. About 24.5% of caretakers had anxiety and 19.6% had depression. The financial, social, and psychological health of caregivers may all impact. The objective was to examine the psychological, financial and social impact on caregivers. A descriptive study was conducted on 207 caregivers’ of mentally ill patients at mental hospital, Nepal. Purposive sampling technique was used. Semi-structured questionnaires were developed to assess psychological and financial impacts and Likert scale questions were included to assess social impact. Information was gathered using a structured face-to-face interview. Impacts on caregivers’ psychological, economic and social were associated to their sociodemographic characteristics. Education, religion, and the patient's length of mental illness were all associated with psychological impact (χ2=54.37; df=5; p= <0.001). Education and the duration of their mental illness are also related to the financial impact (χ2=31.95; df=7; p= <0.001). The social impact experienced by caregivers is similarly associated with education, occupation, and the length of mental illness (χ2=61.03; df=5; p= <0.001). The association between caregivers' sociodemographic factors and the psychological, financial, and social impacts on them was observed. This justifies encouraging caregivers to be a part of the support group in order to increase the information and emotional support they get from other caregivers who have similar experiences. Keywords: Impact, psychological, financial, social, mentally ill patient, caregiver

How do caregivers of children living with HIV/AIDS cope, and where do they get support?: A qualitative study in Ghana

AbstractBackgroundCaring for children living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) is challenging and has a tremendous impact on the physical and psychological health of caregivers. Caregivers of children with HIV/AIDS need to adopt coping mechanisms to navigate these complexities as it influences the quality of care provided. The literature on coping strategies and support (formal and informal) available to caregivers of children living with HIV/AIDS is scant. This study aimed to explore the coping strategies and support systems for caregivers of children living with HIV/AIDS.MethodsA phenomenological study design was adopted. A total of nine participants across three hospitals in the Tamale metropolis were interviewed using purposive sampling. The interviews were audio recorded, transcribed verbatim and analysed using Colaizzi's approach.ResultsFour main themes emerged from the analyses: (1) coping strategies, (2) types of support activities, (3) support from informal institutions and (4) support from formal institutions. The caregivers navigated the caring process with much spiritual coping. The caregivers had little or no support from informal institutions such as immediate family, faith and community leaders. Non‐governmental organizations were not visible in support, and there were no support groups for caregivers.ConclusionSupport for caregivers and the active involvement of the immediate family in paediatric HIV care is imperative.

Effects of dyadic-based physical activity intervention on cancer-related fatigue among cancer survivors: A scoping review.

Cancer-related fatigue is one of the most common adverse reactions to cancer survivors, which has a significant impact on the daily life. As a traumatic event, cancer not only brings great physical and mental harm to patients, but also poses a threat to the physical and psychological health of caregivers. Current studies have shown that physical activity improves cancer-related fatigue in cancer survivors. And studies have suggested that dyadic interventions are more effective in improving patient outcomes and may also provide some benefits to caregivers. But the literature on the effects of dyadic-based physical activity on improving cancer-related fatigue has not been synthesized. This scoping review described the scope and impact of studies on cancer-related fatigue with dyadic-based physical activity interventions. Six databases which is PubMed, Cochrane Library, Web of Science, Embase, CINAHL and Medline were searched for all studies of dyadic-based physical activity interventions with outcome measures including cancer-related fatigue published since the inception of the databases through May 2022. The search strategy was developed based on PICO principles. This article includes 6 pre and post-test designs and 2 randomized controlled trial design. The majority of participants were survivors with breast and lung cancer. The overall results showed that the effectiveness of dyadic-based physical activity interventions in improving cancer-related fatigue was unsatisfactory. This scoping review suggests that current dyadic-based physical activity interventions are not well-researched among cancer survivors. In the future, more high-quality studies with more sophisticated and rigorous interventions are needed.

The Impact of Lethal, Enforcement-Centred Cat Management on Human Wellbeing: Exploring Lived Experiences of Cat Carers Affected by Cat Culling at the Port of Newcastle.

In urban and peri-urban areas of the world, free-roaming cats often pose management challenges for authorities. Most are wandering owned or semi-owned cats (fed by people who do not perceive ownership). Some are lost or abandoned, or unowned cats who obtain food from humans unintentionally. Unidentified cats are classified as "stray" in shelter data, and by government agencies as "stray" or "feral" based on their behaviour. However, legally feral cats are usually considered to live and reproduce in the wild with no support from humans. Cats classified as feral in Australia can be managed using lethal methods, including shooting, poisoning, trapping, and blunt trauma. The impact of killing animals on shelter staff is well documented. However, no previous research has investigated psychological impacts of lethal cat management on citizens who care for free-roaming cats. Using semi-structured interviews, this study explored the lived experience of six cat caregivers affected by lethal management of cats by shooting, instigated by the Port of Newcastle in 2020. Results demonstrated strong relationships between the caregivers and cats, and negative impacts on caregiver psychological health and quality of life associated with lethal management. It is recommended that a care-centred approach to cat management be prioritized in future, whereby authorities aid neutering and, if possible, adoption, to improve cat welfare, minimize cat nuisance complaints, and reduce psychological hazards to caregivers. Further, a revision of relevant legislation used to distinguish between domestic and feral cats in Australia should be actioned to prevent unnecessary killing of domestic cats.

Digital health interventions to support family caregivers: An updated systematic review.

Chronic diseases are the leading causes of death and disability in the U.S., and disease management largely falls onto patients' family caregivers. The long-term burden and stress of caregiving negatively impact caregivers' well-being and ability to provide care. Digital health interventions have the potential to support caregivers. This article aims to provide an updated review of interventions using digital health tools to support family caregivers and the scope of the Human-Centered Design (HCD) approaches. We conducted a systematic search on July 2019 and January 2021 in PubMed, CINAHL, Embase, Cochrane Library, PsycINFO, ERIC, and ACM Digital Library, limiting to 2014-2021 to identify family caregiver interventions assisted by modern technologies. The Mixed Methods Appraisal Tool and the Grading of Recommendations Assessment, Development and Evaluation were used to evaluate the articles. Data were abstracted and evaluated using Rayyan and Research Electronic Data Capture. We identified and reviewed 40 studies from 34 journals, 10 fields, and 19 countries. Findings included patients' conditions and relationships with family caregivers, how the technology is used to deliver the intervention, HCD methods, theoretical frameworks, components of the interventions, and family caregiver health outcomes. This updated and expanded review revealed that digitally enhanced health interventions were robust at providing high-quality assistance and support to caregivers by improving caregiver psychological health, self-efficacy, caregiving skills, quality of life, social support, and problem-coping abilities. Health professionals need to include informal caregivers as an essential component when providing care to patients. Future research should include more marginalized caregivers from diverse backgrounds, improve the accessibility and usability of the technology tools, and tailor the intervention to be more culturally and linguistically sensitive.

Systematic Review and Meta-Analysis of Family Needs Studies: Relationships with Parent, Family and Child Functioning

<p style="text-align: justify;">Findings from a research synthesis of the relationships between family needs and parent, family, and child functioning are reported. The synthesis included 31 studies conducted in 12 different countries. The studies were conducted between 1987 and 2021 and included 4,543 participants. Eight different family needs scales or adaptations of the scales were completed by the study participants (mothers, fathers, or grandmothers of children with developmental disabilities, autism spectrum disorders, or medical conditions). The outcome measures included caregiver psychological health, parenting stress, parenting burden, parenting beliefs, family coping strategies, family functioning, family support, and child functioning. The correlations between family needs and the outcome measures were used as the sizes of effects for evaluating the strength of the relationships between measures. Results showed that unmet family needs were associated with more negative and less positive family and family member functioning and fewer unmet family needs were associated with more positive and less negative family and family member functioning. The sizes of effect for parenting stress and burden were larger than were the sizes of effects for each of the other outcome measures. Child condition and study quality moderated the relationship between family needs and parenting stress and burden but not the other outcome measures. The results are discussed in terms of one component of family systems intervention models.</p>

Family economic hardship and children’s behavioral and socio-emotional outcomes in middle childhood: Direct and indirect pathways

ObjectiveThe current study aimed to examine whether and how family economic hardship would directly or indirectly affect primary school-aged children’s behavioral and socio-emotional outcomes, focusing on the mechanisms of family stress processes. MethodsThis study used four waves of data (kindergarten, first, third, and fourth grade) from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K: 2011). The study sample comprised 13,611 American children whose caregivers responded to questions about the household-level poverty status, the indicator of family economic hardship. Structural equation modeling (SEM) was used to test associations among family economic hardship, family stress processes, and child outcomes in the proposed pathway models. ResultsFamily poverty status was significantly and positively associated with economic pressure, which in turn negatively influenced caregiver psychological health and parenting behaviors, sequentially. Harsh, negative parenting significantly and positively predicts poor child behavioral and socio-emotional outcomes, such as greater levels of externalizing and internalizing behaviors and lower levels of self-control and interpersonal skills. In addition, the relationships between family economic hardship and child outcomes were partially or fully mediated through family stress processes, including parental stress and negative parenting practices. ConclusionFamily poverty is indirectly and significantly associated with primary school-aged children’s poor behavioral and socio-emotional outcomes through caregiver functioning. Given that the middle childhood years are a critical developmental stage in developing increased socioemotional skills, family-based interventions supporting family interactions and/or parental mental health support may help reduce the negative impact of disrupted caregiver functioning on child outcomes along with intervention efforts to alleviate economic hardship.

Voices in Motion: How Social Singing Can Facilitate Psychological Health for Persons With Dementia and Caregivers

Dementia is a global public health priority that exerts significant impact on individuals, families, healthcare systems, and society. Worldwide, over 35 million individuals are estimated to have some subtype of dementia – a projection expected to triple by 2050. Despite progress, a cure for dementia remains elusive, and approved pharmacotherapies are selectively effective for but a limited duration. Increasingly, arts-based interventions for persons with dementia (PwD) and their caregivers are being recognized as inexpensive, non-invasive, and non-pharmacological lifestyle interventions with the potential to improve psychological function as well as reduce healthcare costs. This symposium overviews the Voices in Motion (ViM) study – a sociocognitive intervention exploring the impact of participation in an intergenerational choir on psychological, social, and cognitive function for PwD and their caregivers (n=32 dyads). PwD, caregivers, and local high school students sang in a professionally-conducted choir for as many as three seasons (each ~12 weeks long), spanning up to 18 months of follow-up. Employing an intensive repeated measures design, psychosocial, physiological, and cognitive function was measured every four to six weeks (up to 9 total assessments). The symposium papers provide a representative overview of the broad impact that this novel, non-pharmacological lifestyle intervention can offer vis-à-vis mitigating dementia symptoms and facilitating the psychological health of caregivers. Choir participation has important and significant impacts on psychosocial well-being and quality of life. Discussion focuses on policy implications and the need for community-based programs that reflect a social model for dementia and support living well through engaging and meaningful activities.

Children with cerebral palsy: A cross-sectional study of their sleep and their caregiver's sleep quality, psychological health and well-being.

Children with cerebral palsy (CP) are more likely to experience sleep problems. Their sleep difficulties have been shown to be related to poorer sleep quality for their parents and caregivers. While poor sleep has been linked with poorer psychological health in other populations, few studies have focused on the potential effects of children's and caregivers' sleep disturbance on caregivers' psychological health and well-being in families of children with CP. This study investigated the association between caregivers' psychological health and well-being and their sleep quality and the sleep of their children with CP. Ninety-four caregivers (86% mothers; age range = 29-76 years) of children with CP aged 4 to 14 years of varying physical abilities (Gross Motor Function Classification Scale expanded and revised-level I (24), II (20), III (16), IV (10), V (24)) were recruited from a state-wide rehabilitation service. Caregivers completed the Depression, Anxiety and Stress Scale-21, Warwick-Edinburgh Mental Wellbeing Scale, Resilience Scale, Pediatric Sleep Questionnaire, Pittsburgh Sleep Quality Index, and a demographic questionnaire. Sleep problems were reported for 55% of children. Poor sleep quality was reported by 71% of caregivers. While 25% of caregivers reported positive well-being and 86% reported high to very high levels of resilience, 44% reported poor psychological health. Child sleep problems were related to poorer caregiver sleep quality (r = 0.47, p < 0.001). Poorer caregiver sleep quality was related to poorer caregiver psychological health (r = 0.43-0.51, all p < 0.001) and well-being (r = -0.48, p < 0.001), but not resilience (r = 0.18, p = 0.11). High numbers of children with CP and their caregivers experience poor sleep that extends far past infancy. Poor sleep quality is associated with poorer psychological health and well-being for caregivers. Further development of responsive support services that address caregivers' sleep is essential.

Perception du risque lié au COVID-19, intelligence émotionnelle et santé psychologique des soignants

COVID-19 which appeared in China in 2019 and spread all over the world causing on its way important damages (WHO, 2020). This pandemic has generated stressful situations and significantly hampered the mental and psychosomatic health of the world population, especially that of the medical and paramedical personnel. That is why, we thought it just to focus on the perception of risk, emotional intelligence and the psychological health of caregivers relatively to this dreadful pandemic. This brought us to collect some data through using a composite questionnaire, which we submitted to 180 participants aged between 26 and 63 years (M=17.89, ET=6.56) recruited among health workers. They have selected through the simple random sampling technique. The results of this study permit us to notice that emotional intelligence is correlated to the psychological well being (r(180)=.25; p ≤ .01), while risk perception is correlated to the psychological distress (r(180)=.29; p ≤ .01). This type of results shows the impact of the perception of risk and of emotional intelligence on the psychological health of the health professionals.

Predictors of mental health among parents of children with cerebral palsy during the COVID-19 pandemic in Iran: A web-based cross-sectional study

BackgroundCaring for children with cerebral palsy (CP) for many aspects of their lives may affect caregiver’s psychological health. Emergence of COVID-19 put added pressure on caregivers. AimsThe aim of this study was to investigate the psychological health of Iranian caregivers of children with CP and associated risks during a lockdown period. MethodsUsing online snowball sampling, 160 caregivers of children with CP participated in this web-based cross-sectional study. The Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-4), Caregiver Difficulties Scale (CDS), and a demographic questionnaire were administered. Hierarchical multiple linear regression analysis was applied to identify risk factors related to caregiver psychological health. Outcomes and resultsMental health problems were prevalent; (depression = 45.0% and anxiety = 40.6%). Significant correlations were found between CDS and HADS-Anxiety (r = 0.472, P < 0.001), HADS-depression (r = 0.513, P < 0.001), and perceived stress (PSS) related to COVID-19 (r = 0.425, P < 0.001). After controlling for demographic and clinical variables, burden (CDS) was found to significantly predict caregiver anxiety, depression and stress. Furthermore, several demographic characteristics (being married, low educational level and low income) were significantly related to high HADS Anxiety scores. For depression, only having a physical problem was significantly related to HADS among demographic variables. No significant correlations were found between PSS-4 and demographic variables. Conclusions and implicationsDuring COVID-19 outbreak, the mental health of caregivers of children with CP is affected by multiple factors such as burden of care and demographic characteristics. Due to the importance of well-being among caregivers of disabled children, a comprehensive plan including psychological consultation, remote education, or in-person handouts for the self-care or handling of the children and adequate distance support may enable better mental health for these caregivers.

Caregiver-Oncologist Prognostic Concordance, Caregiver Mastery, and Caregiver Psychological Health and Quality of Life.

Caregivers of adults with cancer often report a different understanding of the patient's prognosis than the oncologist. We examine the associations of caregiver-oncologist prognostic concordance with caregiver depressive symptoms, distress, and quality of life (QoL). We also explore whether these relationships differed by caregiver environment mastery, an individual's sense of control, and effectiveness in managing life situations. We used data from a national geriatric assessment cluster-randomized trial (URCC 13070) that recruited patients aged 70 years and older with incurable cancer considering any line of cancer treatment at community oncology practices, their caregivers, and their oncologists. At enrollment, caregivers and oncologists estimated the patient's prognosis (0-6 months, 7-12 months, 1-2 years, 2-5 years, and >5 years; identical responses were concordant). Caregivers completed the Ryff's environmental mastery at enrollment. At 4-6 weeks, caregivers completed the Patient Health Questionnaire-2 (depressive symptoms), distress thermometer, and 12-Item Short-Form Health Survey (quality of life [QoL]). We used generalized estimating equations in models adjusted for covariates. We then assessed the moderation effect of caregiver mastery. Of 411 caregiver-oncologist dyads (mean age = 66.5 years), 369 provided responses and 28% were concordant. Prognostic concordance was associated with greater caregiver depressive symptoms (β = 0.30; p = .04) but not distress or QoL. A significant moderation effect for caregiver depressive symptoms was found between concordance and mastery (p = .01). Specifically, among caregivers with low mastery (below median), concordance was associated with greater depressive symptoms (β = 0.68; p = .003). Caregiver-oncologist prognostic concordance was associated with caregiver depressive symptoms. We found a novel moderating effect of caregiver mastery on the relationship between concordance and caregiver depressive symptoms. Caregiver-oncologist prognostic concordance is associated with greater caregiver depressive symptoms, particularly in those with low caregiver mastery. When discussing prognosis with caregivers, physicians should be aware that prognostic understanding may affect caregiver psychological health and should assess their depressive symptoms. In addition, while promoting accurate prognostic understanding, physicians should also identify strengths and build resilience among caregivers.

The Magic of Music for Improving Psychological Health for Those With Dementia and Their Caregivers

Arts-based interventions for person’s with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between- and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual’s personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.

Development and Validation of a Gujarati Questionnaire for Evaluating Levels of Awareness, Acceptance, Socio-Economic Stress &amp; Expectations from Physiotherapy Services in Parents of Children with Cerebral Palsy

Parents of children with cerebral palsy experience anxiety, depression, guilt and low self-esteem, frustration, low matrimonial and personal satisfaction etc. While planning interventions for the child with cerebral palsy, physiotherapist should consider physical and psychological health of caregivers, influence of social support, family functioning etc. This study gives an overview of the procedure for development and validation of a Gujarati questionnaire to evaluate levels of awareness, acceptance, stress &amp; expectations from physiotherapy services through two-stage process. At the 1st stage domain determination, item generation and instrument formation was done. In the 2nd stage, face and content validation was done using consensus method by a group of 10 experts. As a result, questionnaire having 9 dimensions and 84 items with acceptable levels of validity was developed.

Prevalence and correlates of psychiatric morbidity in Egyptian sample of dementia patients\u2019 caregivers: a comparative descriptive study

BackgroundA strong relationship between dementia caregiving and negative consequences on psychological health of caregivers has been established in numerous studies. A meticulous evaluation of caregiver mental status function is of utmost importance to gain better insight into daily caregiver functioning and to alleviate their high levels of burden. This study evaluated the prevalence of psychiatric morbidities and their sociodemographic and clinical correlates among a sample of dementia caregivers in Egypt. Twenty-five caregivers of patients with dementia were collected and compared with regard to their psychiatric morbidity with 25 careers of patients with chronic physical diseases. Patients were subjected to Mini-Mental State Examination (MMSE) and Arabic versions of activities of daily living (ADL) and instrumental activities of daily living (IADL), and caregivers were interviewed using the Arabic version of the General Health Questionnaire (GHQ), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and Zarit Burden Interview (ZBI).ResultsCaregiver’s burden was significantly higher among the dementia caregiver group than the non-dementia group. Moreover, dementia caregivers provided more aid with a higher total of ADLs and provided help for more IADLs than did the non-dementia caregivers. They also showed higher psychiatric morbidity. Such morbidity was found to be related to hours of caring, years of caring, GHQ, ZBI, ADL/IADL, BPSD, and MMSE. On the other hand, ADL, IADL, and GHQ scores had the highest predictive significance of caregiver’s burden in our study.ConclusionsCaregivers of patients with dementia are subjected to more burden and vulnerability to psychiatric disorders than the other caregiver group. That should raise a flag to pay extra support and care for those people, which in turn will benefit both the patient and the health care authorities in terms of quality and cost of the care provided.

THE MAGIC OF MUSIC FOR IMPROVING PSYCHOLOGICAL HEALTH FOR THOSE WITH DEMENTIA AND THEIR CAREGIVERS

Arts-based interventions for person’s with dementia and their caregivers represent an inexpensive, non-invasive, and non-pharmacological intervention with the potential to improve psychological function as well as reduce healthcare costs. The paper presents an overview of Voices in Motion (ViM), and the impact of this social-cognitive intervention on changes in psychological function for those with dementia and their caregivers (current n=26 dyads). Choir rehearsals were held on a weekly basis, and included a social discussion component. A range of outcomes (neuropsychological and physiological function, neural activation) were assessed using an intensive repeated measures design that facilitates both between- and within-person analyses, including nuanced evaluation of whether psychological function improves post intervention relative to an individual’s personal average, yielding a conservative within-person test of the benefits of intervention. Discussion focuses on the promise of such interventions for mitigating dementia symptoms and facilitating the psychological health of caregivers.

Caregiver Burden and Related Factors Among Caregivers of Patients with Myotonic Dystrophy Type 1.

Multi-systemic symptoms of varying severity in myotonic dystrophy type 1 (DM1) may pose difficulties in caregiving. However, the factors which affect their care burden are yet to be sufficiently understood. We investigated care burden and its correlates among caregivers of patients with DM1. General demographic information was obtained from patients with DM1, as well as Barthel index (ADL), body mass index, and genetic information. Patients completed SF-36v2 (health-related quality of life), CES-D (depressive symptoms), and ESS (daytime sleepiness) questionnaires. Caregivers reported their perception of patient's status through these questionnaires, and completed Zarit Caregiver Burden Interview (ZBI). Correlation analysis of these variables were performed, and regression analysis was utilized to assess the relationship between caregiver burden and other variables. Forty-three patient-caregiver dyads participated. Mean ZBI score was 20.7±17.4, and 32.6% reported a significant care burden. ZBI correlated with caregiver-reported CES-D, but not with patient-reported CES-D. Both patient-reported and caregiver-reported physical QoL of patients correlated with patient ADL. Multiple regression analysis revealed that the combination of caregiver-reported CES-D, caregiver-reported mental QoL, and genetic characteristics predicted caregiver burden. Caregiver burden was felt although patients were relatively well-functioning. Patients' and caregivers' assessment of patients' physical condition were similar. However, they did not agree on the evaluation of the patients' psychological state. Cognitive characteristic of the patients and the caregivers' perception of the patients' state may have affected the results. Future DM1 care strategies need to work on improvement of patient-caregiver communication and provide support for the caregiver's psychological health.

Impacts of a multicomponent intervention programme on neuropsychiatric symptoms in people with dementia and psychological health of caregivers: A feasibility pilot study.

The objectives of this study are to explore the feasibility of a multicomponent intervention programme and to evaluate its impacts on behavioural and psychological symptoms of dementia (BPSD) and psychological health of caregivers. Fifty-six community-dwelling people with dementia (PWD) and knee osteoarthritis (OA) and their caregivers were recruited and randomized into the intervention group (IG) or comparison group (CG). Each participant in both groups received an individual physiotherapy session (personalized home exercises and care education) and underwent 8 weeks of a 1-hour-structured group exercise session weekly at a day care centre. They were instructed to follow the prescribed home exercise. The IG received a multicomponent programme, combining knee OA-specific therapeutic exercise with self-management support, while the CG attended the routine group exercise programme. The attendance rate and reasons for non-attendance were recorded for evaluating the feasibility. The Chinese versions of the Revised Scale for Caregiving Self-Efficacy (RSCSE) and the Neuropsychiatric Inventory Questionnaire (NPI-Q) were measured at the baseline and postintervention. Fifty-four dyads completed the programme with high attendance rate (94.4%). Compared with the CG, caregivers in the IG significantly improved in three domains of RSCSE scores (P ≤ .005) and caregivers' distress (P = .004) after the intervention. However, no effects were observed in terms of BPSD severity in PWD. No adverse events or falls were reported. This multicomponent programme is feasible and safe for dementia caregivers and older people with mild-to-moderate dementia and knee OA. The programme has beneficial effects on caregiving self-efficacy and distress of dementia caregivers.

Psychiatric Symptoms in Patients With Dementia: Do Caregivers and Doctors See the Same Thing?

Neuropsychiatric symptoms (NPS) are common in Alzheimer Disease (AD). Treatment could be optimized by supplementing the clinician's impression of a patient with information from the caregiver. Yet the agreement between caregivers and physicians on the presence of NPS in patients with AD is understudied. Data were obtained from a 2-staged survey in neurology outpatient offices. At stage 1, patients (n=403) were documented by their physicians, including an assessment on the presence of NPS. At stage 2, patients' CGs (n=171) were asked about the presence of NPS in the patients, based on questions from the Neuropsychiatric Inventory. Caregivers were screened for depression with the Depression Screening Questionnaire. The study sample comprised patients with mild or moderate AD. NPS frequency varied between 52.6% [95% confidence interval (CI), 44.9%-60.3%] and 67.2% (95% CI, 59.7%-74.2%, reported by CGs) and 34.2% (95% CI, 26.8%-42.1%) and 50.9% (95% CI, 42.9%-58.9%, reported by physicians). Apathy, depression, aggression, and irritability occurred most frequently according to both sources. κ values were lowest for euphoria (κ=0.03; 95% CI, -0.08 to 0.25), and highest for depression (κ=0.26; 95% CI, 0.11-0.43). CG depression was associated with an increased probability (odds ratio=2.9; 95% CI, 1.2-6.7) of disagreement between caregivers and physicians on the patient's mental status. NPS, though very prevalent in dementia patients, are perceived differently by caregivers and physicians. This divergence increases depending on the psychological health of caregivers.