Caregiver Status Research Articles

Investigation on Behavioral Change in Hospitalized School-Age Young Patients and Influencing Factors

Background: Hospitalization has been a source of anxiety for young school-age patients. In addition to taking care of young patients’ physical problems, the primary caregivers will also encounter young patients’ emotional reactions. Understanding the anxiety status in young patients and primary caregivers to provide relevant measures is an important issue.Aim: To investigate the hospitalization anxiety levels in school-age children aged 6 to 12 years and primary caregivers, as well as their influencing factors.Subject and Methods: Cross-sectional research with a questionnaire survey was used as the methodology for the study. The enrollment period was between December 1, 2021, and August 31, 2022. For hospitalized young patients aged 6 to 12 years in the orthopedic ward of a medical center, after the consent was acquired at admission for 24 hours, the primary caregiver was assigned to complete the questionnaire.Result: The Post-Hospitalization Behavior Questionnaire (PHBQ) was used to investigate 39 young patients. The overall mean behavior scores was 51.5 ± 15.7 points, there were statistically significant differences for sex in general anxiety behavior scores, separation anxiety behavior scores, sleep anxiety behavior scores, apathy/withdrawal behavior scores, and total behavior scores, with higher post-hospitalization behavior scores in male young patients compared to that in females. In the Trait Anxiety Inventory for a family member, the mean score was 39 ± 12.6 points, with mild anxiety at 50%, moderate anxiety at 38.9%, and severe anxiety at 11.1%. Primary caregivers’ level of anxiety reached statistical significance in economic status, with an increased level of anxiety for those who were in lower economic positions (p=0.01).Conclusion: The PHBQ for young patients can be used as an assessment for their levels of anxiety, the levels of negative behaviors in boys are higher than that in girls. There were 50% of primary caregivers experienced moderate to severe anxiety, and the sources of anxiety were correlated with the economic status of the family.Recommendations:(1) Hospital anxiety in children is often overlooked and can be found by observing behavior. The PHBQ is an easy-to-use assessment tool and is recommended for routine use in hospitalized children to assess behavioral changes after pediatric surgery/hospitalization to help parents and medical staff evaluate children's anxiety.(2) Hospitals can construct amusement equipment, and toys or arrange game activities to reduce the anxiety of hospitalization of school-age children.

Associations between caregiving status, acculturation, and psychological distress in a diverse sample.

Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults. Secondary data analysis of the California Health Interview Survey (CHIS). The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161). Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables. First generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers. Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.

Prevalence of depression in caregivers of stroke patients in Karachi, Pakistan

OBJECTIVES
 To determine the frequency of depression in caregivers of stroke patients at a tertiary care teaching hospital in Karachi Pakistan.
 METHODS 
 A cross-sectional study was conducted among caregivers of stroke, who were recruited from the Aga Khan University Hospital Karachi Pakistan, between January 2018 to October 2018. Data was collected through the Urdu Hamilton rating scale for depression (HAM-D-U) and it was analyzed using descriptive and inferential statistics.
 RESULTS
 A total of 136 caregivers participated in the study. Among them, 44.1 % were male and 55.9% were female. The mean age of caregivers was 45.38 ± 10.33 years. Using the HAM-D-U scale, depression was present in 64 (47.1%) caregivers. Out of them (n=64), 46 (33.8%) caregivers had mild depression whereas 18 (13.2%) had moderate depression. Depression was found to have a significant relationship with the age of the patient (p=0.002), education level of caregiver (p= 0.012), employment status of caregiver (p=0.012), being a sole caregiver (p=0.039), and monthly family income (p=0.016).
 CONCLUSIONS
 Caring for patients with neurological disorders is highly challenging and demanding. The need for this role may arise unexpectedly in one’s life; leaving little space for adjustment and coping. Depression itself can be very paralyzing for the sufferer especially if moderate to severe in intensity. Depression in stroke caregivers can be missed as patients are the center of a clinical visit. Hence, strategies should be designed and reinforced to screen patients and caregivers for depression along with a pathway for an easy and timely referral.

Resilience Level of the Family Caregivers of the Elderly in Mashhad, Iran During the COVID-19 Pandemic

Background & Aims Resilience is defined as a person’s ability to maintain psychological balance and recover from challenging conditions. Due to the very important role of family caregivers in the treatment of older patients with COVID-19, attention to their health and well-being has been increased. This study aims to determine the resilience level of the family caregivers of older people during COVID-19 pandemic in Mashahd, Iran. Materials & Methods This descriptive-analytical study was conducted on 120 family caregivers of older people who referred to urban health centers in Mashhad, Iran. Sampling was done in using cluster random sampling method from April to June 2022. The instrument was a two-part questionnaire included demographic form (surveying age of the elderly and caregiver, gender of caregiver, educational level of caregiver, employment status of caregiver, marital status of caregiver, and the relation of caregiver with the elderly) and the Connor-Davidson resilience scale. Data analysis was done in SPSS v.23 software using descriptive and inferential statistics. Results The mean age of family caregivers and elderly were 39.94±1.32 and 74.44±3.17 years, respectively. The age of caregivers ranged 20-74 years and the age of the elderly ranged 60-89 years. The mean resilience score of caregivers was 49.40±13.07, which is low. There was a significant relationship between resilience score and educational level (P<0.05), marital status (P<0.001) and employment status of family caregivers (P<0.05). The correlation between resilience and caregiver’s age (r=0.17) and elderly’s age (r=0.13) was positive, but weak. Conclusion Family caregivers of the elderly in Mashhad city have low resilience. Their educational level, employment status, and marital status are related to their resilience level. Attention to these factors can help health care providers to develop plans for increasing their resilience and improving the quality of life of the elderly.

Factors associated with Alzheimer’s disease patients’ caregiving status and family caregivingburden in China

AbstractBackgroundThe increasing prevalence of Alzheimer’s disease (AD) has emerged as a major challenge worldwide. China as the most populous country in the globe is amid rapid aging of its population, highlighting the need for appropriate social and medical policies to meet the challenge. The current study aims to provide understanding of the current status of caring given to AD patients in China and the underlying factors with a large multicenter cross‐sectional observational approach.MethodA total of 1675 patients with probable AD from 30 provincial regions of mainland China were enrolled in the current study from August 2019 to December 2019. We analyzed the caregiving status and its relationship with family burden and various socioeconomical and medical factors.Result90.87% of the patients enrolled adopted family care. The choice of caregiving method was influenced by factors including age (>80 years old, OR 0.648; 95% CI, 0.427–0.983), overall family burden (high, OR 0.574; 95% CI, 0.0.373–0.884),patients’ income (OR 0.511; 95% CI, 0.330–0.789) and self‐care ability (OR 0.329; 95% CI, 0.183–0.588).ConclusionFamily care is the primary method of care for AD patients in China and the institutional care system for AD patients is still underprepared in China.

Understanding characteristics of persons with early onset dementia in the UCLA Alzheimer’s and Dementia Care Program

AbstractBackgroundAlthough early onset dementia (EOD) accounts for approximately 5% of persons living with dementia (PLWD), there is limited understanding of their demographic characteristics, behavioral symptoms, and caregiver measures, especially in comparison to persons with older onset dementia (OOD).MethodThe UCLA Alzheimer’s and Dementia Care Program is a comprehensive dementia care management program that has served over 3450 PLWD since 2012. This retrospective study compares baseline visit characteristics of participants with EOD (≤ 65 years of age) to participants with OOD (≥ 80 years of age). Variables include patient and caregiver demographics, Neuropsychiatric Inventory Questionnaire (NPI‐Q) scores, Mini Mental State Exam (MMSE), Modified Caregiver Strain Index (MCSI), caregiver PHQ‐9, and insurance status. Fisher exact tests were used to test differences between age groups.ResultThe attached table presents comparisons of the 177 participants with EOD and 731 with OOD. Compared to OOD, persons with EOD were more likely to be men, college graduates, dually insured, have unpaid caregivers, live alone, and be married. Caregivers for persons with EOD were most often spouses, whereas caregivers for persons with OOD were more often children. Although participants had similar MMSE scores, NPI‐Q severity and NPI‐Q distress scores were higher among persons with OOD compared to EOD.ConclusionThere are important differences in demographic characteristics, caregiving status, and behavioral symptoms among persons with EOD compared to those with OOD. Understanding the unique challenges, needs, and resources of persons with EOD may provide valuable insight to adapt dementia care to better meet their needs.

Sleep disturbance has the largest impact on children's behavior and emotions.

Children's behavior and emotions are affected by sleep disturbances, the parent-child relationship, media viewing time, and the social status of parents and caregivers. We conducted a questionnaire survey to identify the factors that have the greatest impact on children's behavior and emotions and how these factors relate to each other. A parental questionnaire survey was performed at a public elementary school. The questionnaire comprised questions on the family environment (e.g., family structure, media and game exposure, after-school lessons, and caregiver's work schedule) and physical information, the Strengths and Difficulties Questionnaire (SDQ), the Children's Sleep Habits Questionnaire (CSHQ), and the Pittsburgh Sleep Quality Index (PSQI) for parents' sleep condition. A path diagram was drawn to hypothesize the complex interrelationships among factors, and structural equation modeling was used to estimate the path coefficients. We identified several factors that significantly affected the SDQ score. The CSHQ total score had the largest impact, followed by after-school lessons, single-mother families, and children's sex. In addition, several indirect pathways that led to the CSHQ score (i.e., a pathway from time spent watching television to CSHQ score via children's bedtime and a pathway from single-mother family to CSHQ score via PSQI total score) significantly affected the SDQ score. Children's sleep habits that were influenced by several environmental factors had the greatest impact on children's behavior and emotions, which suggested that children's behavioral problems can be improved by interventions focused on sleep habits, such as sleep hygiene instructions.

Resilience and caregiving ability among caregivers of people with stroke: The mediating role of uncertainty in illness.

In China, stroke survivors are usually cared for by their family members. However, the caregiving ability of these informal caregivers remain inadequate during the hospitalization of their family members following a sudden onset of a stroke, and this sudden need for care overwhelms caregivers even after the hospital discharge. Therefore, research is required to identify predictors of caregiving ability that could be targeted in future interventions aimed at improving caregiving skills and reducing the burden on caregivers who care for stroke survivors. From August 2019 to February 2020, stroke survivors were hospitalized for the first time, and their family caregivers were registered via convenience sampling. Caregiver demographic information, resilience status, uncertainty in illness, caregiving ability, and patients' severity of stroke were measured using standardized questionnaires. Structural equation modeling was used to test the proposed model, where caregiver resilience and stroke severity predicted caregiving ability directly, and uncertainty in illness mediated the association between caregiver resilience and caregiving ability. A total of 306 dyads were included in the study. The tested model fit the data well (χ2 = 118.2, df = 64, RMSEA = 0.053, CFI = 0.946, TLI = 0.923). Statistically significant pathways linked caregivers' resilience status to uncertainty in illness (β = -0.558, S.E. = 0.022, P < 0.01), caregivers' resilience to the status of caregiving ability (β = -0.269, S.E. = 0.013, P < 0.01) and caregivers' uncertainty about the illness to caregiving ability (β = 0.687, S.E. = 0.051, P < 0.01). We also found that caregivers' uncertainty in illness mediated the association between caregivers' resilience and caregiving ability (β = -0.384, S.E. = 0.061, P < 0.01). Our structural equation modeling result identified resilience and uncertainty about the illness as predictors of the caregiving ability of informal family caregivers who suffered from care burdens. Supporting family caregivers to build their resilience and reduce illness uncertainty may improve caregiving for stroke survivors.

Abstract 13134: Weight Neutral Intervention Improves Metabolic Syndrome Status in Family Caregivers

Introduction: Weight neutral approaches to obesity management may be more effective than traditional weight loss programs. Weight neutral approaches include self-esteem improvement, intuitive eating, and sustainable physical activity (PA) and can reduce cardiometabolic markers without significant weight loss. Hypothesis: We hypothesize that psychoeducation plus exercise intervention will improve cardiometabolic biomarkers related to metabolic syndrome (MetS). Methods: This secondary data analysis from a randomized controlled intervention trial of sedentary family care givers aimed to improve perceptions of caregiving and physical function. A subgroup of the original trial was studied: the psychoeducation group (PE) and psychoeducation plus exercise (PE+EX) groups and those that had blood glucose above 90 ng/dL. The PE group received printed and video instructions of stretching and a 4-week self-care intervention. The PE+EX group received the same plus a 12-week aerobic and resistance PA program. Measurements were at baseline (BL) and 6 months. Univariate comparisons between treatment groups at 6 months were reported. Results: Participants (n=74) had a mean age of 57 years, 87% female, 74% Black, 69% were college educated, mean body mass index (BMI) of 32.3 kg/m2 at BL which did not change significantly by 6m (BMI 32.1, paired t-test p=0.186). Of the 23 that had MetS at baseline in the PE group, 13 (57%) no longer had MetS at 6 months and 2 (13%) worsened. In the PE+Ex group, 12 of the 18 (68%) no longer had MetS at 6 months and 3 (17%) worsened. Overall, there was a positive change in MetS status between BL and 6 months (McNemar’s p&lt;0.001). Of all MetS components, waist circumference (WC) showed significant improvement (14.8% with at risk waist circumference improved, p=0.021). Overall, 39 of 74 (53%) decreased their MetS risk by 1-3 factors from BL to 6 months (Wilcoxon, p&lt;0.001). There was no significant difference between the groups (p=0.358). Conclusions: We conclude that a psychoeducation intervention either alone or with an exercise component showed improvement in MetS status. Future studies should design weight neutral interventions with the intent on changing behavior around diet and exercise combined.

Predictors of caregiver burden in caregivers of older people with physical disabilities in a rural community.

Caring for an aging society is a problem facing many countries including Thailand. This cross-sectional study investigated caregiver burden and related predictive factors among 69 caregivers who had older family members with physical disabilities. Burden Scale, World Health Organization Quality of Life-Bref Thai (QOL), Patient Health Questionnaire-9 (PHQ), Barthel Activity of Daily Living Index (ADL), and Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) assessments were used in addition to demographic data. Thirteen caregivers (18.8%) reported no caregiver burden, 30 (43.5%) reported low-moderate burden, 21 (30.4%) reported moderate-high burden and 5 (7.2%) reported high burden. Using Fisher's Exact Test the factors found to be significantly associated to caregiver burden were: categorical age of the caregiver (p = .000), education level of the caregiver (p = .002), relationship to the care recipient (p = .009), categorical income level of the caregiver (p = .041), QOL of the caregiver (p = .001) and ADL status of the care recipient (p = .003). Forward stepwise linear regression model revealed three factors which were PHQ score (β = .543, p &lt; .000), ADL score (β = -.341, p = .001) and hours of care/week (β = .227, p = .017). Future studies should focus on interventions that impact depression levels, independence with activities of living and hours of care per week.

What counts as discrimination? How principles of merit shape fairness of demographic decisions.

Demographic attributes (e.g., age, disability, race) frequently affect people's decisions. We provide a novel perspective as to why such discrimination persists: Meritocratic principles lead people to perceive some demographic attributes as fair to use, rather than as discriminatory. Specifically, we theorize that meritocracy requires that controllable and relevant inputs determine outcomes; as a result, perceived controllability and relevance affect the degree to which demographic attributes are perceived as fair to use. Moreover, we suggest perceived relevance outweighs controllability, such that even uncontrollable attributes can be perceived as fair criteria if perceived to be outcome relevant. In two qualitative studies, we probed how people think about demographic attributes used in selection (Studies 1a-b). We find that people refer to controllability and relevance dimensions to justify their perceptions. Further, people largely associate uncontrollable, irrelevant attributes with discrimination (race, sex), neglecting attributes they perceive as controllable and/or relevant (disability, caregiving status). Next, three surveys (Studies 2a-c) support our theorizing that perceived relevance impacts fairness perceptions more strongly than perceived controllability. In three experiments (Studies 3a-c), we provide causal evidence that relevance and controllability shape perceived fairness, which in turn affects selection behaviors, including seeking information regarding demographic attributes during hiring. Finally, Study 4 demonstrates downstream consequences: Perceived controllability, relevance, and use of demographic attributes together impact employees' psychological safety and job satisfaction. Overall, we find that principles of merit lead people to believe that even some legally protected demographic attributes are fair to use, allowing discrimination to persist. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

186 FRAILTY IN HOSPITALISED OLDER ADULTS AND THEIR SPOUSES: A CROSS-SECTIONAL STUDY

Abstract Background Hospital admissions are a critical time-point for assessing frailty. Frail older adults have high utilisation of healthcare resources and many require on-going care. Often spouses provide this care, however caregiving can lead to increased frailty in the caregiver. A description of frailty and caregiving within marital dyads has not been explored previously, in relation to hospital admissions. Methods Aim: To measure the frequency and describe the characteristics of frailty in hospitalised older adults and their spouse. Objectives were to: (1) Describe frailty, physical and cognitive performance in patients and spouses; (2) Determine frailty correlations between dyads; (3) Establish if patients are more likely to have spouses of the same frailty classification; (4) Describe caregiving within the context of frailty. Participants were recruited from geriatric and stroke services from October 2019-March 2020. Fried Frailty Phenotype (FFP) was used to test frailty. Clinical Frailty Scale, Grip Strength, Montreal Cognitive Assessment, Timed Up and Go, Geriatric Depression Scale and self-reported: mobility status, caregiving status, number of falls and number of hospital admissions were also assessed to describe the population. Results Data from 27 dyads that participated and consented were analysed using SPSS. A total of 15 patients (55.5%) and four spouses (14.8%) were classified as frail. Of 15 frail patients, four had frail spouses, five had pre-frail spouses and six had robust spouses. No pre-frail or robust patients had frail spouses. Spearman’s Correlational analysis showed no correlation in FFP between patient and spouse (r=0.24, p=0.23). Participants that provided care (44.4%) accounted for 5 patients (frail n=4) and 19 spouses (frail n=4). Conclusion Frailty in dyads is heterogeneous. Caregivers are commonly frail and provide care to frail partners. Older adults admitted to hospital should be assessed for frailty. If the patient has a spouse, especially if the patient is frail, their spouse should be assessed for frailty.

Factors associated with mental health outcomes among caregivers of older adults in long-term care facilities during COVID-19 post-epidemic era in Shandong, China.

BackgroundCOVID-19 pandemic has altered the work mode in long-term care facilities (LTCFs), but little is known about the mental health status of caregivers of older adults.MethodsA total of 672 formal caregivers of older adults in LTCFs and 1,140 formal patient caregivers in hospitals (comparison group) responded to an online survey conducted from March 25, 2022 to April 6, 2022. Five psychological scales, including Insomnia Severity Index (ISI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), The 5-item World Health Organization Wellbeing Index (WHO-5) and Perceived Stress Scale-14 item (PSS-14), were applied to assess participants’ mental health status. Factors, including sex, profession, marital status, economic conditions, length of working experience, frequent night shift beyond 1 day per week and having organic diseases, were included in logistic regression analysis to identify associated factors with mental health outcomes of formal caregivers of older adults in LTCFs.ResultsCaregivers of older adults in LTCFs developed similar severe psychological symptoms with patient caregivers in hospital setting. For caregivers of older adults in LTCFs, unmarried status was a potent risk factor for insomnia, anxiety, impaired wellbeing and health risk stress, with odds ratios ranging from 1.91 to 3.64. Frequent night shift beyond 1 day per week was associated with higher risks of insomnia, depression and impaired wellbeing. Likewise, having organic disease or inferior economic condition, and being nurses appeared to be independent predictors for multiple mental health-related outcomes.ConclusionDuring COVID-19 post-epidemic era, caregivers of older adults in LTCFs had a higher prevalence of psychological symptoms, especially those with particular risk factors. Special attention should be paid to promote their mental health.

Caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers: A cross-sectional analytical study

Objectives: Oncology caregivers often endure a significant amount of psychosocial stress while going through the experience of caregiving for their dependents. Exposure to chronic stress disrupts the cardiac autonomic balance and increases the risk of cardiovascular events. There is a paucity of research on the association between caregiving strain and cardiac autonomic status of primary oncology caregivers. This study aimed to assess the cardiac autonomic balance and its association with the levels of perceived strain and quality of life (QOL) of primary oncology caregivers. Materials and Methods: Forty-six individuals (30 males and 16 females) who have been primary caregivers of patients under the treatment for cancer at the Regional Cancer Centre over the past 3 months–1 year were recruited in this cross-sectional study. Cardiac autonomic status was assessed by heart rate variability (HRV) technique. The level of strain perceived and QOL of the study participants were assessed using the Modified Caregiver Strain Index (MCSI) and Caregiver QOL-Cancer (CQOL-C) questionnaires, respectively. Comparison of study parameters based on MCSI scores (low strain vs. moderate-high strain) was done using the Independent Student’s t-test. Spearman rank correlation coefficient test was performed to assess the correlation between sympathovagal balance (Low frequency [LF]/high frequency [HF]) and other study parameters. Multiple linear regression analysis was performed to predict the LF/HF ratio with independent variables MCSI score and CQOL-C score. P &lt; 0.05 was considered statistically significant. Results: Significantly high blood pressure, LF power, LF nu (LF normalised units) and LF/HF ratio were observed among caregivers with moderate-to-high caregiving strain as compared to those with low strain levels, while significantly low HF nu (HF normalised units) and CQOL-C scores were noted among the moderate-to-high caregiving strain subgroup as compared to the low caregiving strain subgroup. LF/HF ratio revealed a significant positive correlation with the level of caregiving strain (r = 0.563, P &lt; 0.001) and a significant negative correlation with the QOL (r = −0.489, P = 0.001) of caregivers. However, on regression analysis, the level of caregiving strain was found to be a significant predictor of autonomic dysfunction unlike the caregivers’ QOL. Conclusion: Increased caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers.

Depression Among the Caregivers of Breast Cancer Patients and its Association with the Quality of Life.

This study investigated the prevalence of depression among the Jordanian caregivers of patients with breast cancer and its effect on their health-related quality of life (QOL). This was a cross-sectional study with a sample that consisted of 122 caregivers recruited from 2 hospitals in Jordan over 5 months. A validated questionnaire was used to assess the prevalence of depression symptoms and the aspects of QOL among the participants using Beck's Depression Inventory-II score and the 36-Item Survey Form (SF-36) score. Depression symptoms were revealed in 27.9% of caregivers. Regarding the QOL, the mental health (MH) subscale was considerably associated with caregivers' age (P=0.007). The marital status of caregivers was significantly associated with pain (Bodily Pain BP) (P=0.015), Beck's Depression Inventory (BDI; P=0.009), and social functioning (SF) (P=0.008). The number of caregivers' siblings was considerably associated with MH (P=0.040) subscale. The monthly income of caregivers was associated with BP (P=0.042). The residency of caregivers was considerably connected with role limitations because of emotional problems (RE) (P=0.027) and role limitations due to physical health (RF) (P=0.013) subscales. There was a significant correlation between the existing family history of depression with RF (P=0.009), RE (P=0.005), SF (P=0.003), and energy/fatigue (Vitality VT) (P=0.001) subscales. Furthermore, the physical activity of caregivers was connected with the RF (P=0.030), general health (GH) (P=0.018), RE (P=0.015), and MH (P=0.003) subscales. Around a third of the caregivers revealed depression symptoms. The QOL subscales for these caregivers were connected with various health and social factors, such as age, number of siblings, marital status, monthly income, residency, family history of depression, and physical activity. The evaluation of the mental and physical well-being of caregivers should always be considered and managed to help them to cope with their QOL.

Influence of psychological responses of caregiving on the perceived health of family caregivers to acute stroke survivors.

Family caregivers provide round-the-clock care to their family members who had a stroke. The detrimental effects of caregiving on caregiver’s health would lead to the abandonment of caregiver role and institutionalization of stroke survivors. This study aims to determine the factors associated with the perceived health status of family caregivers to stroke survivors. This study conducted a secondary analysis of the baseline data of 142 family caregivers of stroke survivors nested within a longitudinal randomized controlled trial. Potential factors were identified according to the Pittsburgh Mind-Body Center model and were analyzed with hierarchical multiple regression models. The results indicated that stroke caregivers exhibited comparable perceived physical health with general population but poorer perceived mental health. Severity of depressive symptoms (β = −0.37, P < .001) remained the strongest and most significant factor associated with perceived mental health, followed by confidence in problem-solving (β = −0.21, P < .05). Moreover, caregiving competence (β = 0.29, P < .001) was the sole significant psychological factor associated with perceived physical health. Caregiving competence, problem-solving abilities, and severity of depressive symptoms are significant modifiable correlates of the perceived health of caregivers. Intervention for improving these psychological responses of caregivers is suggested incorporated in stroke rehabilitation programs.

The Impact of the COVID-19 Pandemic on Internet Use and the Use of Digital Health Tools: Secondary Analysis of the 2020 Health Information National Trends Survey.

BackgroundThe COVID-19 pandemic increased the use of digital tools in health care (eg, patient portal, telemedicine, and web-based scheduling). Studies have shown that older individuals, racial/ethnic minority groups, or populations with lower educational attainment or income have lower rates of using digital health tools. Digitalization of health care may exacerbate already existing access barriers in these populations.ObjectiveThis study evaluated how use of digital tools to asynchronously communicate with clinicians, schedule appointments, and view medical records changed near the beginning of the pandemic.MethodsUsing 2020 Health Information National Trends Survey (HINTS) data, we examined internet use and 7 digital health technology use outcomes (electronic communication with a provider, electronic appointment scheduling, electronic test result viewing, patient portal access, portal use to download health records, portal use for patient-provider communication, and portal use to view test results). The HINTS surveyors designated surveys received after March 11, 2020, as postpandemic responses. Using weighted logistic regression, we investigated the impact of the pandemic after adjusting for sociodemographic traits (age, race/ethnicity, income, education, and gender), digital access (having ever used the internet and smartphone/tablet ownership), and health-related factors (insurance coverage, caregiver status, having a regular provider, and chronic diseases). To explore differences in changes in outcomes among key sociodemographic groups, we tested for significant interaction terms between the pandemic variable and race/ethnicity, age, income, and educational attainment.ResultsThere were 3865 respondents (1437 prepandemic and 2428 postpandemic). Of the 8 outcomes investigated, the pandemic was only significantly associated with higher odds (adjusted odds ratio 1.99, 95% CI 1.18-3.35) of using electronic communication with a provider. There were significant interactions between the pandemic variable and 2 key sociodemographic traits. Relative to the lowest income group (<US $20,000), the highest income group (≥US $75,000) had increased growth in the odds of ever having used the internet in postpandemic responses. Compared to the most educated group (postbaccalaureates), groups with lower educational attainment (high school graduates and bachelor’s degree) had lower growth in the odds of using electronic communication with a provider in postpandemic responses. However, individuals with less than a high school degree had similar growth to the postbaccalaureate group in using electronic communication with a provider.ConclusionsOur study did not show a widespread increase in use of digital health tools or increase in disparities in using these tools among less advantaged populations in the early months of the COVID-19 pandemic. Although some advantaged populations reported a greater increase in using the internet or electronic communication with a provider, there were signs that some less advantaged populations also adapted to an increasingly digital health care ecosystem. Future studies are needed to see if these differences remain beyond the initial months of the pandemic.

Awareness of the Malaria Vaccine in India.

Background: Malaria remains a serious public health problem in India. According to the World Health Organization (WHO), as per the 2021 report, India accounts for 83% of malaria cases in Southeast Asia. Various interventions have been implemented to control malaria's burden in India. In October 2021, the WHO approved the RTS,S/AS01 (RTS,S) malaria vaccine for administration in four scheduled doses in children five months of age to reduce the burden and severity of malaria. The objectives of this study were to assess public awareness about the vaccine among residents of India and determine any associations with demographic characteristics.Methods: The study was a web-based, cross-sectional survey. The survey questionnaire was sent out electronically using Qualtrics® (Provo, UT) and remained active for 12 weeks (December 2021 to March 2022). The questionnaire was self-administered anonymously, using a link that was shared with people across India through social media platforms. A total of 2,371 respondents above 18 years of age and current residents of India participated in the study. The chi-square test was used to examine the association between awareness about the vaccine and demographic characteristics. A p-value of <0.05 was used to describe a statistically significant association.Results: Most participants (71.95%) had heard about the malaria vaccine, and 68.75% favored making it a required childhood vaccine. Similarly, 67.27% indicated that they would encourage caregivers to get their children/wards vaccinated. Age, gender, educational status, residence, and caregiver status were associated with the awareness regarding the malaria vaccine (p < 0.05). Males, participants between 18 and 24 years old, and caregivers of children aged five years or less were more likely to be aware of the vaccine. Participants with higher education and residing in urban localities had more awareness of the vaccine.Conclusion: The malaria vaccine has the potential to eradicate malaria in India, especially if included in the immunization schedule for children. However, it is critical that health policymakers target populations that are less aware of information on any intended rollout of the malaria vaccine to ensure rapid uptake toward the goal of eliminating malaria from India.

Can social networks improve job search behaviours among low-income youth in resource-limited settings? Evidence from South Africa

ABSTRACT Previous studies have established the importance of social networks in determining youth employment outcomes. The quality and quantity of social entities in social networks and effectively using them, have a positive influence on employment outcomes. However, limited evidence exists on the composition and role of social networks on youth employment in resource-limited countries. Our study addresses current evidence gaps by investigating the association of social networks and job search behaviours in a sample of South African youth who are neither in employment, education, or training (NEET). Our results indicate that the association of social networks with job search behaviours depends on the type of social network and job search behaviours. Having more people in youth’s social network was associated with a higher likelihood of attending a job interview but no association with job applications’ submission. Additional family members were positively associated with job interviews, as well. Age, gender, relationship status, geographic residence, formal postsecondary education, training experience, caregiver status, and mobile phone ownership were also associated with job search behaviours. Overall, our findings indicate that social networks, particularly family members, are more predictive of job interviews than job applications.

Use of P-CPQ to measure the impact of oral health on the quality of life of children with special health care needs

Introduction and objective: the WHO defined the concept of quality of life as the self-perception that the individual has about his position in the social, cultural and ideological context, being these factors the main responsible for denoting the worst parameters regarding oral health care during the dental clinical examination performed by the dentist. To evaluate the impact of oral health on the quality of life of children with special health care needs aged 7 to 14 years old and the influence of different types of specialties on the quality of life, in the view of parents/caregivers in the Brazil southeast region. Materials and methods: the sample was composed of 62 children enrolled in municipal public schools and the Association of Parents and Friends of the Exceptional. The validated Parental- Caregivers Perception Questionnaire (P-CPQ) was used as an instrument for data collection, applied in the home environment and answered by the main responsible. The relation between demographic factors, type of special need and P-CPQ was evaluated with alpha of 0.05. Results: the worst parameters in Family Impact Scale were observed when the mother and father was responsible for data transmission (p= 0.004). Oral health was associated with the worst parameters of oral symptoms on quality of life in the view of parents (p = 0.012). There was no statistically significant difference regarding the impact of the child's type of specialty on quality of life. Conclusion: the variables caregiver and oral health status child are related to the worst indicators regarding the impact of oral health on quality of life.