Caregiver Social Support Research Articles

The influential factors of anxiety among caregivers of children with CL/P: a path analysis based on diathesis-stress theoretical model.

This study aims to validate a hypothesized model of the relationships between optimism, resilience, coping, parenting stress, perceived social support, and anxiety, as well as their influencing factors and consequences among caregivers of children diagnosed with cleft lip and/or palate (CL/P). A hypothesized model was proposed based on diathesis-stress theoretical model and existing literature. A convenience sample of two CL/P treatment centers in China was collected between April 2019 and July 2020. Various well-validated instruments were used to collect 248 valid data points. Descriptive statistics and correlations were computed to assess model fitness and path analysis was performed to investigate direct and indirect effects. The results revealed that the average level of anxiety among caregivers of children suffering from CL/P was 3.00 (0.00,6.00). The fitness of the modified path model was evaluated using various measures, including χ2/df = 1.806, GFI = 0.989, RFI = 0.916, IFI = 0.990, CFI = 0.989, TLI = 0.960, RMSEA = 0.0570. Parenting stress had the greatest direct associated with anxiety, followed by perceived social support. Moreover, indirect relations to anxiety were observed for optimism, resilience, and coping, which were mediated through perceived social support and parenting stress. In summary, this work suggests that both parenting stress and perceived social support in caregivers of children suffering from CL/P are associated with anxiety. Therefore, developing effective intervention approaches targeting key factors might potentially instrumental to alleviate anxiety.

Feasibility and Acceptability of a Self-Guided Digital Family Skills Management Intervention for Children Newly Diagnosed With Type 1 Diabetes: Pilot Randomized Controlled Trial.

Family dynamics play an important role in determining the glycemic outcomes of type 1 diabetes (T1D) in children. The time interval immediately following T1D diagnosis is particularly stressful for families, and interventions to support families in adjusting their family practices to support adjustment to and management of T1D in the months following diagnosis may improve glycemic outcomes. Self-guided digital interventions offer a sustainable model for interventions to support caregivers in learning evidence-based family management skills for adjustment to and management of T1D. We hypothesized that a self-guided, web-based, family skills management program (addressing caregiver social support as well as family problem-solving, communication, and supportive behavior change strategies) initiated at the time of T1D diagnosis would improve glycemic outcomes in children with T1D. In this study, we report on the feasibility and acceptability of this program. We prospectively evaluated a sample of 37 children newly diagnosed with T1D recruited from a pediatric endocrinology clinic. Parent participants were asked to complete web-based modules addressing social support, family problem-solving, communication, and supportive behavior change strategies. Module completion was analyzed for percentage completion, patterns of completion, and differences in completion rates by coparenting status. Qualitative open-ended feedback was collected at the completion of each module. A total of 31 (84%) of the 37 participants initiated the web-based program. Of those 31 participants, 25 (81%) completed some content and 15 (48%) completed all 5 modules. Completion rates were higher when coparenting partners engaged in the intervention together (P=.04). Of the 18 participants given a choice about the spacing of content delivery, 15 (83%) chose to have all sessions delivered at once and 3 (17%) chose to space sessions out at 2-week intervals. Qualitative feedback supported the acceptability of the program for delivery soon after T1D diagnosis. Families reported on positive benefits, including requesting future access to the program and describing helpful changes in personal or family processes for managing T1D. In this study, we found that a self-guided digital family support intervention initiated at the time of a child's T1D diagnosis was largely feasible and acceptable. Overall, rates of participation and module completion were similar to or higher than other self-guided digital prevention interventions for mental and physical health outcomes. Self-guided digital programs addressing family management skills may help prevent challenges common with T1D management and can decrease cost, increase access, and add flexibility compared to traditional interventions. ClinicalTrials.gov NCT03720912; https://clinicaltrials.gov/study/NCT03720912.

Good Friends and Good Neighbors: Social Capital and Food Insecurity in Families with Newborns

To examine the association between social capital and household food insecurity among US families with newborns. This cross-sectional analysis used enrollment data from 881 newborn-caregiver dyads at six geographically-diverse US academic sites enrolled in the Greenlight Plus Trial, a comparative effectiveness trial to prevent childhood obesity. Ordinal proportional-odds models were used to characterize the associations of two self-reported measures of social capital: 1) caregiver social support and 2) neighborhood social cohesion, with household food insecurity after controlling for sociodemographic characteristics. Among 881 newborn-caregiver dyads (49% Hispanic, 23% non-Hispanic white, 17% non-Hispanic Black; 49% with annual household income <$50,000), food security was high for 75%, marginal for 9%, low for 11% and very low for 4%. In covariate-adjusted analyses, caregivers with a low social support score of 18 had five times the odds (aOR=5.03 95%CI=3.28-7.74) of greater food insecurity compared with caregivers with a high social support score of 30. Caregivers with a low neighborhood social cohesion score of 10 had nearly three times the odds (aOR=2.87 95%CI 1.61-5.11) of greater food insecurity compared with caregivers with a high neighborhood social cohesion score of 20. These associations remained robust when both social capital measures were included in one model. Caregiver social support and neighborhood social cohesion each appear to be inversely associated with food insecurity among US families with newborns. Longitudinal research is needed to determine the directionality of these relationships and whether improving social capital for families with young children reduces household food insecurity.

Psychosocial Correlates of the Experience of Caregiving Among Caregivers of Patients With Schizophrenia.

Family caregivers provide essential support to their loved ones with schizophrenia with profound outcomes for themselves. The caregiver burden fails to consider the entire caregiving experience, which also incorporates positive aspects of caring. Many potentially significant variables are associated with this. To examine the correlates of the experience of caregiving in caregivers of patients with schizophrenia. The specific objectives were to examine the socio-demographic variables of the patients and caregivers, clinical variables of the patient, caregivers' knowledge of illness, caregivers' perspectives of family functioning, caregiver coping, their social support, psychological distress, quality of life,and their spirituality, religiosity and personal beliefs and the associations of these variables with the caregivers' experience of caregiving. This cross-sectional observational study was conducted between August 2018 and January 2021 at All India Institute of Medical Sciences, New Delhi, India. One hundred and fifty-eightdyads of patients with schizophrenia and their family caregivers were recruited using purposive sampling. Experience of Caregiving Inventory was used to evaluate the caregiving experience. The caregivers were also assessed on socio-demographics, knowledge of illness, family functioning, coping, social support, general mental health, quality of life, and spiritual, religious, and personal beliefs. Patient socio-demographics and clinical variables were also assessed. A negative experience of caregiving was reported by caregivers of patients who had higher positive or negative symptoms of schizophrenia. Impaired Communication, Roles, Affective Responsiveness, Affective Involvement, and General Functioning aspects of family functioning were associated with a negative experience of caregiving. Denial/blame and seeking social support as coping were also associated with a negative experience of caregiving. A negative experience of caregiving was significantly positively correlated with greater psychological distress and poorer quality of life. Greater inner peace was associated with a less negative experience of caregiving. Spiritual strength was associated with a more positive experience of caregiving. Knowledge of mental illness and caregiver social support were not significantly associated with the experience of caregiving. Experience of caregiving is a relevant construct, the understanding of which can help inform caregiver-directed interventions in the future. Specifically, family-based interventions, which include ameliorating patient symptomatology, improving the family environment, strengthening caregivers' coping strategies, attending to caregiver distress, and encouraging spirituality among caregivers, may lead to a less negative and more positive experience of caregiving; and a better quality of life for caregivers.

Impact of the COVID-19 Pandemic on Latino Families With Alzheimer Disease and Related Dementias: Qualitative Interviews With Family Caregivers and Primary Care Providers.

Latino individuals experience disparities in the care of Alzheimer disease and related dementias (ADRD) and have disproportionately high COVID-19 infection and death outcomes. We aimed to gain an in-depth understanding of the impact of the COVID-19 pandemic among Latino families with ADRD in the United States. This was a qualitative study of 21 informal caregivers of Latino individuals with ADRD and 23 primary care providers who serve Latino patients. We recruited participants nationwide using convenience and snowball sampling methods and conducted remote interviews in English and Spanish. We organized the transcripts for qualitative review to identify codes and themes, using a pragmatic approach, a qualitative description methodology, and thematic analysis methods. Qualitative analysis of transcripts revealed eight themes, including (1) the pandemic influenced mental and emotional health; (2) the pandemic impacted physical domains of health; (3) caregivers and care recipients lost access to engaging activities during the confinement; (4) the pandemic impacted Latino caregivers' working situation; (5) the pandemic impacted health care and community care systems; (6) health care and community care systems took measures to reduce the impact of the pandemic; (7) Latino families experienced barriers to remote communication during the pandemic; and (8) caregiver social support was critical for reducing social isolation and its sequalae. Latino families with ADRD experienced similar but also unique impacts compared to those reported in the general population. Unique impacts may result from Latino individuals' underserved status in the United States, commonly held cultural values, and their intersectionality with ADRD-related disability. Family caregiver social support was crucial during this time of adversity. These findings suggest the need for more equitable access, culturally appropriate and trustworthy content and delivery of health care and community services, as well as stronger financial and social supports for family caregivers.

A Quasi-experimental study on the effectiveness of primary caregiver social support capacity on self-management practices of clients living with type II diabetes in Machakos county, Kenya

Background: Diabetes is a fast-growing public health emergency, projected to affect 643 million people by 2045. While primary caregiver social support can influence the self-management practices of Type 2 diabetes (T2D) clients, there's often limited capacity to provide it. The study determined the effectiveness of enhanced caregivers' social support capacity on self-management practices of T2D clients in Machakos. Methods: A six-month quasi-experimental study design that adopted quantitative and qualitative data collection and analysis approaches. Primary caregivers at the Matungulu intervention site were trained on T2D self-management and types of social support, with no intervention conducted at the Masinga control site. Results: Over 90% of the 227 primary caregivers were female, with a mean age of 43.28, supporting approximately three T2D clients each. Post-intervention, a 27.2% change in capacity to identify all T2D self-management practices was noted compared to a 7.6% change in the control group. The greatest contribution was in the primary caregivers' ability to provide tangible, followed by emotional and informational social support, resulting in a statistically significant improvement in the self-management practices in the intervention site, B=0.140 (95% CI: 0.072, 0.208), t=4.046, p&lt;0.001. Consequently, the difference in blood glucose levels was statistically significant, crude OR=3.213 [95% CI: 2.039, 5.063], p&lt;0.001. Conclusions: Enhanced capacity to provide social support positively correlates with the T2D clients' self-management practices. Further investigation of factors that hinder the full realization of primary caregiver social support capacity benefits in improving self-management capacities among T2D clients is recommended.

An examination of characteristics, social supports, caregiver resilience and hospital readmissions of children with medical complexity.

Children with medical complexity (CMC) account for 1% of children in the United States. These children experience frequent hospital readmissions, high healthcare costs and poor health outcomes. A link between CMC caregiver social support, resilience and hospital readmissions has never been fully investigated. This study examines the feasibility of a prospective, descriptive, repeated measures research design to characterize CMC and their caregivers, social supports, caregiver resilience and hospital readmissions to inform a larger prospective investigation. Caregivers of CMC with unplanned hospitalizations completed surveys at the index hospitalization and 30 and 60 days after discharge. CMC caregiver and child characteristics, social supports and hospital readmissions were examined using an investigator-developed survey. Resilience was measured using the Resilience Scale-14© (7-Point Likert Scale, score range 14-98), and feasibility was measured by calculating enrolment, attrition, survey completion and item response. Analysis included descriptive statistics and qualitative data visualization. Of caregivers who were approached for participation, 81.1% consented and completed 76 surveys. Attrition was 31%. Item response rates were ≥ 90% for all but one item. A total of 62.1% of children had hospital readmissions within 90 days and 37.9% within 30 days. Additionally,70% of caregivers had home care nursing, but the approved hours were only partially filled. More than 70% of caregiver resilience scores were moderate to high (score range 74-98) and were stable across repeated measures and hospital readmissions. Open-ended question responses revealed the following five categories: All-consuming, Family Reliance, Impact of Covid, Taking Action and Broken System. Studying CMC caregiver social supports and resilience using repeated measures is feasible. CMC caregivers reported stressors including coordinating their child's substantial healthcare needs and managing partially filled home care nursing hours. Caregiver resilience remained stable over time, amidst frequent CMC hospital readmissions. Findings can inform future research priorities and power analyses for CMC caregiver resilience.

Effect of the Caregivers-to-Caregivers Training Programme on informed caregivers of persons with mental disorders: A pilot study.

Many people with mental disorders are cared for by informed caregivers, but they usually have limited care-related training and lack caregiving capacity and support networks. In order to provide professional training and social support for informed caregivers, we designed the Caregivers-to-Caregivers Training Programme (C2C) and performed a pilot study to assess its effect. Caregivers of persons with mental disorders who participated in the C2C were asked to participate in a quasi-experimental study to assess their knowledge and skills development, self-care ability, trainer engagement, and training content. A total of 800 participants completed self-designed evaluation questionnaires and two open-ended questions to gather suggestions and feedback. Assessments were carried out at pretest (baseline), post-test, and at 2-month follow-up. Results were analyzed using one-way repeated measures analysis of variance (ANOVA) and pairwise comparison method. At post-test, 667 assessments were considered valid and 515 were deemed valid at 2-month follow-up. One-way repeated-measures ANOVA showed that the main effect of the scores on knowledge and skills development and self-care ability from baseline to 2-month follow-up was significant (p < .001). Results of pairwise comparison method showed that the scores on each item of knowledge and skills development and self-care ability at post-test and at 2-month follow up were higher than those at baseline (p < .001). The scores on items of trainer engagement and training content were all above average (4/5). The open-ended questions resulted in 678 comments indicating that participants gained significant support from other caregivers and healthcare professionals in the alliance and wanted more and continuously updated material. This study demonstrated that C2C effectively improved the development of caregivers' knowledge, skills, and their self-care ability. Available social support for caregivers was better than average, including professional support and peer support.

COVID-19 Stress and Child Behavior: Examining Discrimination and Social Support in Racially Diverse ECHO Cohorts

To examine the additive or moderating influences of caregiver COVID-19-related stress, social support, and discrimination on children's behavior problems across racially diverse populations. In this Environmental influences on Child Health Outcomes (ECHO) cohort study (N= 1,999 caregiver/child pairs), we operationalized caregiver COVID-19-related stress in 2 ways: first, as the number of stressors (eg, financial concerns, social distancing); and second, as the level of pandemic-related traumatic stress symptoms reported via questionnaires administered between April 2020 and August 2022. At the same assessment visit, caregivers also reported their current levels of discrimination, and a subsample (n= 968) reported their emotional and instrumental support. Either concurrently or at a later assessment visit, caregivers reported on their children's internalizing and externalizing behavior problems using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18). Multivariable analyses controlling for maternal education, marital status, child age, and child sex revealed that COVID-19-related stress (caregiver stressors and symptoms) and discrimination were positively associated, and that perceived support was negatively associated with child internalizing and externalizing behavior problems. Unexpectedly, neither emotional nor instrumental support attenuated the relationship between caregiver COVID-19-related stressors nor traumatic stress symptoms and child behavior problems. In the subset of Black American participants, caregiver perceived discrimination moderated the relationship between caregiver COVID-19 traumatic stress symptoms and child internalizing problems, such that the association was stronger at higher levels of discrimination. Our findings highlight the potential importance of relieving caregiver stress and increasing caregiver social support to optimize children's behavioral outcomes.

Disparities in Depression and Anxiety That Impact Self-Identified Sexual Minority People Affect a Broader Group of Same-Gender Attracted Young Adults

PurposePrior work suggests sexual minority (e.g., gay, bisexual) young adults are at greater risk for depression and anxiety. However, the majority of said work focuses exclusively on self-reported sexual minority identity and neglects same-gender attraction. The current study aimed to characterize links between identity- and attraction-based indicators of sexual minority status and depression and anxiety in young adults, and to examine the ongoing significance of caregiver support in mental health during this key developmental period. Methods386 youth (mean age = 19.92 years; SD = 1.39) reported their sexual orientation identity and experiences of attraction toward men and/or women. Participants also reported on anxiety, depression, and caregiver social support. ResultsWhile less than 16% of participants identified as sexual minority individuals, nearly half reported same-gender attraction. Self-identified sexual minority participants reported significantly higher depression and anxiety than self-identified heterosexual participants. Similarly, same-gender attracted individuals exhibited heightened depression and anxiety compared to exclusively different-gender attracted individuals. Greater caregiver social support predicted lower depression and anxiety. DiscussionThe present findings suggest that not only are self-identified sexual minority individuals at heightened risk for depression and anxiety symptoms, but also that this risk extends to a larger group of young people who experience same-gender attraction. These results demonstrate that better mental health supports may be needed for youth who identify as sexual minority individuals or report same-gender attraction. That higher caregiver social support was associated with lower mental illness risk suggests caregivers may be key to mental health promotion during young adulthood.

Depression status and functional outcome of patients with ischemic stroke and the impact on caregivers living in Chengdu: a cross-sectional study.

To investigate the associations between risk factors and depression symptoms in ischemic stroke (IS) survivors and the effect of IS survivors' depression status and functional outcomes on caregiver burden in Chengdu, China. In this cross-sectional study, we recruited a convenience sample of patients with IS and paired caregivers living in Chengdu from February 2022 to May 2022. Depression symptoms were assessed using the 17-item Chinese Hamilton Depression Rating Scale, the social support of patients was assessed using the perceived social support scale (PSSS), caregiver burden was assessed using the Zarit burden interview (ZBI). Multivariable logistic regression analysis was used to analyze the data between risk factors and depression symptoms, and multiple linear regression models were constructed to examine the depression symptoms and functional outcomes of stroke survivors, and caregiver burden. In total, 966 IS survivors and paired caregivers were included in this study. Among IS survivors, 35.51% (343/966) experienced depression. Age [adjusted odds ratio (aOR), 1.02; 95% confidence interval (CI), 1.00-1.04; p = 0.036], the National Institutes of Health Stroke Scale (NIHSS) score (aOR, 1.57; 95% CI, 1.47-1.68; p < 0.001), and PSSS score (aOR, 0.86; 95% CI, 0.84-0.89; p < 0.001) were associated with an increased risk of depression. The NIHSS score (b = 2.57, p < 0.001), patients' depression status (b = 2.54, p < 0.001), duration of care (b = 0.359, p = 0.006), and social support of caregivers (b = -0.894, p = 0.038) were significantly associated with the ZBI score. The PSSS score was a major risk factor for the development of depression in IS survivors, and patients' depression status and severe functional deficits had a negative impact on the ZBI score of the main caregivers. Social support can reduce the ZBI score.

Perceptions of an educational intervention for family caregivers of palliative care patients.

Nursing interventions aimed at family caregivers of palliative cancer patients require not only an objective evaluation, but also subjective consideration of their contributions, and a qualitative evaluation that provides an in-depth understanding of these interventions. This study aimed to explore the perceptions that family caregivers of palliative cancer patients had of the nursing intervention, PalliActive Caregivers, in reducing the uncertainty associated with illness and improving the caregiver's quality of life. A qualitative approach with content analysis was used. Telephone interviews were conducted with 23 caregivers who participated in the intervention. Five themes emerged from the content analysis: consolidating physical care, adopting a positive attitude, strengthening the support available to the caregiver, strengthening spirituality and strengthening relationships. The themes showed a positive impact of the intervention on aspects such as the caregiver's ability to cope, spirituality and social support of caregivers. The results also indicated the possibility of conducting this type of study to identify other assessment variables for future interventions.

Perceived stress, social support, and insomnia in hemodialysis patients and their family caregivers: an actor-partner interdependence mediation model analysis.

Patients' and caregivers' physical and mental health may interact. The theory of dyadic illness management holds that patients and caregivers should be regarded as a whole in health management. Previous studies have found that hemodialysis patients and their family caregivers experience poor sleep quality. Perceived stress and social support have effects on insomnia. However, the dyadic interaction between perceived stress, social support, and insomnia among hemodialysis patients and caregivers is unclear. This study aimed to explore the mediating role of social support in the association between perceived stress and insomnia in hemodialysis patient-caregiver dyads. A total of 259 hemodialysis patient-caregiver dyads completed the Chinese Perceived Stress Scales (CPSS), the Perceived Social Support Scale (PSSS), and the Athens Insomnia Scale (AIS) in Lanzhou, China, from May 2022 to July 2022. The actor-partner interdependence mediation model analysis was used for data analysis. In the actor effect, there was a significant positive correlation between perceived stress and insomnia in hemodialysis patients (β = 0.091, p = 0.001) and their family caregivers (β = 0.588, p < 0.001). Patient's and caregiver's social support played partial mediating roles in the relationship between caregiver's perceived stress and insomnia (β = 0.135, p < 0.001 and β = 0.111, p < 0.001). In the partner effect, caregiver's perceived stress was positively connected with patient's insomnia (β = 0.915, p < 0.001), and the mediating effect of patient's social support on the relationship between caregiver's perceived stress and patient's insomnia was statistically significant (β = -0.040, p = 0.046). The perceived stress, social support and insomnia of hemodialysis patients and their family caregivers had interactive effects. Effective dyadic-based interventions should be developed to improve hemodialysis patients' and caregivers' sleep quality.

Older Adult Caregivers' Perspectives on Wound Care Resources: A Qualitative Study.

With an aging population, increasing numbers of older adults are assuming a caregiving role, including performing complex care procedures, such as wound care. Access to and use of resources are associated with better physical and mental health for caregivers. A thematic analysis of qualitative interviews with adult caregivers aged ≥65 years performing wound care identified seven resources supportive of the caregiver role, including: (a) access to expert guidance from health care professionals; (b) written instructions; (c) relationships with health care professionals for obtaining wound care supplies; (d) need for additional medical equipment; (e) financial resources; (f) coverage for caregiver personal time; and (g) select persons for caregiver social and emotional support. Given that older adults are increasingly cast into caregiver roles in the home setting, providing resources to sustain care recipients and their caregivers is critical. [Research in Gerontological Nursing, 16(4), 194-201.].

The Context of Caregiving in Heart Failure: A Dyadic, Mixed Methods Analysis.

Caregiving for persons with heart failure (HF) varies based on the individual, family, and home contexts of the dyad, yet the dyadic context of HF caregiving is poorly understood. The aim of this study was to explore dyadic perspectives on the context of caregiving for persons with HF. Family caregivers and persons with HF completed surveys and semistructured interviews. Investigators also photographed caregiving areas to complement home environment data. Descriptive qualitative analysis resulted in 7 contextual domains, and each domain was rated as strength, need, or neutral. We grouped dyads by number of challenging domains of context, categorizing dyads as high (≥3 domains), moderate (1-2 domains), or minimal (0 domains) needs. Quantitative instruments included the 36-item Short Form Health Survey, ENRICHD Social Support, HF Symptom Severity, and Zarit Burden Interview. We applied the average score of each quantitative measure to the groups derived from the qualitative analysis to integrate data in a joint display. The most common strength was the dyadic relationship, and the most challenging domain was caregiving intensity. Every dyad had at least 2 domains of strengths. Of 12 dyads, high-needs dyads (n = 3) had the worst average score for 7 of 10 instruments including caregiver and patient factors. The moderate-needs dyads (n = 6) experienced the lowest caregiver social support and mental health, and the highest burden. Strengths and needs were evident in all patient-caregiver dyads with important distinctions in levels of need based on assessment of multiple contextual domains. Comprehensive dyadic and home assessments may improve understanding of unmet needs and improve intervention tailoring.

Burden and social support in caregivers of people with kidney disease: a systematic integrative review

The task of providing care to patients with chronic kidney disease can lead caregivers to experience burden. Social support can be a strategy to assist caregivers in coping with the demands of their caregiving task. The article aimed to synthesize the evidence available in the literature on social support and burden among caregivers of adult people with chronic kidney disease. It consists of a systematic integrative review conducted according to what was proposed by Whittemore and Knalf. The databases MEDLINE, Psyco INFO, Web of Science, CINAHL, LILACS, and Scopus were searched, without restrictions on language or year of publication. Nine studies published between the years 2013 and 2022 were included. The caregivers are usually married women of working age. According to the results of the selected articles, it is suggested that social support is an important strategy to deal with the burden stemming from the caregiving task. It is concludes that social support seems to be an important resource for caregivers of people with CKD (including social support provided online). More research with higher methodological rigor is needed to shed light on the depth of knowledge on this topic.

Three-year outcomes of a fracture liaison service model at a university-based tertiary care hospital in Thailand

SummaryFragility hip fracture (FHF) is a serious complication of osteoporosis. A fracture liaison service (FLS) is crucial in preventing FHF. Our retrospective data of 489 patients with FHF and 3-year follow-ups demonstrated that the FLS improved functional outcomes. Our study’s mortality rates were lower than in other published series.PurposeThis study assessed the 3-year outcomes after fragility hip fracture (FHF) treatment by a multidisciplinary team from the Siriraj Fracture Liaison Service (Si–FLS). The review investigated the administration rates of anti-osteoporosis medication, refracture, and mortality; activities of daily living; mobility; and health-related quality of life.MethodsA retrospective review was performed of the records of Si-FLS patients given FHF treatment between June 2016 and October 2018. The outcomes were evaluated at 3 time points: before discharge, and 1 and 3 years after treatment.ResultsThe study enrolled 489 patients (average age, 78). The mortality and refracture rates at 1 year after hip fracture were 13.9% and 1.6%, respectively. At the 3-year follow-up, both rates were higher (20.4% and 5.7%, respectively). The Barthel Index and EuroQoL Visual Analogue Scale had risen to a plateau at the 1-year follow-up and remained stable to the 3-year follow-up. One year after treatment, approximately 60% of the patients could ambulate outdoors, and the proportion remained steady until the 3-year follow-up. There was no difference in the 1- and 3-year follow-up anti-osteoporosis medication administration rates (approximately 40%).ConclusionsThis study confirms the benefits of having a multidisciplinary FLS care team to manage older people with FHF. An FLS improves the care of patients with FHF and the social support of caregivers and relatives. The FLS maintained the functional outcomes of the patients through 3 years of postfracture treatment.

Abstract B115: A qualitative study on caregiving social support among Hispanic/Latino parents of childhood cancer survivors in a safety-net hospital

Abstract Background: Parents are the primary caregivers throughout their child's cancer journey. As a result, they may experience a shift in their self and social identity both immediately and in the long term after their child is diagnosed with cancer. Insights into Hispanic/Latino parents of childhood cancer survivors' social support is limited, however. This qualitative study aimed to address the existing gap by describing the social support experiences of Hispanic/Latino parents while caregiving. Methods: Caregivers were recruited from a safety-net hospital in Los Angeles County between July to September 2020. Qualitative semi-structured interviews were conducted with 15 Hispanic/Latino caregivers of childhood cancer survivors (in English and Spanish). The interviews were audio-recorded, professionally transcribed, and analyzed following a reflexive thematic analysis approach. Two coders independently reviewed and coded transcripts and used grounded theory methodology elements (e.g., gerund coding and memo-writing) on Dedoose. Results: Two related themes were identified: the positive influence of social support when available and the challenges associated with lack of social support. All caregivers spoke about the positive influence of social support throughout their caregiving experience (both during and after treatment). Participants' descriptions of the influence of social support included (1) information sharing enhanced knowledge, (2) receiving comfort and encouragement, (3) receiving tangible assistance reducing the caregiving burden, and (4) enhancing caregiving empowerment/self-efficacy. The most common form of social support among these caregivers was tangible assistance, which included financial support for groceries, bills, rent, and essential services such as transportation, work hour flexibility, childcare for other children, and help with household maintenance. Sub-themes regarding the lack of social support included (1) being a single parent and (2) family and friends withdrawing after the child's cancer diagnosis. Single parents described juggling multiple roles, including caring for the patient, maintaining financial support for the entire family, and caring for other children while managing their child's illness. One caregiver expressed that "if there were two of us [during treatment], it would have been easier." Conclusion: When a child is diagnosed with cancer, parents are the primary caregivers and the presence or absence of social support may impact their caregiving experience, particularly for Latino/Hispanic caregivers who are medically underserved. The findings of this study indicate that Hispanic/Latino parents strongly value social support as it enables them to have essential resources that support caregiving for their child and themselves. Efforts should ensure that caregivers are routinely screened to identify their supportive needs. In an effort to optimize support services for caregivers, it needs to be tailored as those with a lack of social support may experience excessive caregiver burden. Citation Format: Carol Ochoa, Randall Y. Chan, Lissette Cervantes, Kimberly A. Miller. A qualitative study on caregiving social support among Hispanic/Latino parents of childhood cancer survivors in a safety-net hospital [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B115.

Pandemic-Related Disruption and Positive Adaptation: Profiles of Family Function at the Onset of the Pandemic.

The onset of the pandemic brought heightened stress to parents due to disruptions to family life, in addition to processes of positive family adaptation, including greater closeness, more time spent together, and shared problem-solving. Delineating how early pandemic-related family stress and positive adaptation simultaneously operate is important for understanding risk and resilience. We use a person-oriented approach to identify subgroups of caregivers based on patterns of stress and positive adaptation in the first months of the pandemic. Data come from a multi-national study of 549 caregivers (68% female) of 1098 children (younger child: M = 9.62, SD = 3.21; older child: M = 11.80, SD = 3.32). In May 2020, caregivers reported on stress (income, family, and pandemic-specific) and positive adaptation using previously validated scales, and covariates indexing family vulnerabilities (i.e., caregiver adverse childhood experiences, caregiver and child mental health) and psychosocial resources (caregiver social support, positive coping, religiosity/spirituality, and benevolent childhood experiences, and pre-pandemic socioeconomic resources). A latent profile analysis was conducted using the four indicators. Profiles were examined in relation to covariates using BCH procedures. A 4-profile solution was selected, characterized by Low Disruption (n = 296), Multi-Domain Disruption (n = 36), Income Disruption (n = 111), and Family Disruption (n = 106) groups. Positive adaptation minimally differentiated profiles. Participants in the Low Disruption group reported more resources and fewer vulnerabilities than other groups. Those in the Multi-Domain Disruption group reported the fewest resources and the most vulnerabilities. Early in the pandemic, a minority group of individuals in this sample carried a disproportionate burden of pandemic-related stress. Potential consequences to family functioning and implications for systemic family prevention and intervention efforts are discussed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s42844-022-00077-7.

The Influence of Different Types of Social Support in Caregivers of People with Dementia.

Being a caregiver for a person with dementia has negative health consequences, like depression, stress, anxiety, and burden. Consequently, it is important that caregivers receive social support and social resources during the trajectory of the disease. This study analyzes how different types of social resources impact caregivers' well-being. A cross-sectional sample of 260 caregivers was divided into groups, depending on the social resources they had access to. Namely, social media (N = 157), day-care centers (N = 40) or residential centers (N = 63). Social support, isolation, burden, coping strategies, and satisfaction measures were administered to participants, and groups were compared using ANOVA and SEM models. Help-seeking and social support received through social resources predicted satisfaction and caregivers' burden. Formal resources positively influence care providers and their absence diminishes the impact of social support on perceived burden. This research reflects the importance of formal resources in the lives of caregivers and the benefits they generate throughout the course of the pathology. Supporting caregivers and bringing the social resources closer to them indirectly improves the informal response offered to people with dementia.