scholarly journals Interventions to Enhance Resilience Among Family Caregivers: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 151-152
Author(s):  
Nai-Ching Chi ◽  
Soojeong Han ◽  
Ying-Kai Fu ◽  
Lynn Nakad ◽  
George Demiris

Abstract Long-term caregiving can negatively impact caregivers’ physical and psychological well-being and are associated with increased morbidity and mortality among caregivers. A more positive caregiving experience is associated with increased coping skills and resilience. Caregiver-targeted interventions designed to promote caregivers’ resilience may lead to improved caregivers’ well-being, the quality of caregiving, and care recipients’ outcome. However, a comprehensive evaluation of effective interventions that enhance resilience among caregivers is lacking. Therefore, the purpose of this study is to critically evaluate existing training programs to inform clinical practice and future program design. A literature review was conducted to search available articles published before June 2018 in databases including PubMed, CINAHL, PsycINFO, and Scopus. Search strategies used index and keyword methods. The inclusion criteria were peer-reviewed, research studies published in English that evaluated an intervention primarily aimed to improve family caregivers of adult patients’ resilience or had a primary outcome of resilience. Seven studies fit the criteria identified. Six studies used psychosocial therapy and one used pharmacological therapy to promote caregivers’ resilience. Several effective resources were identified, such as counseling, self-help manuals, psychoeducation, cognitive behavioral therapies, and the use of an antidepressant. All studies reported positive improvements in caregivers’ outcomes and six studies reported caregivers had improved resilience after receiving interventions. However, most interventions require health professionals to train patients and caregivers for multiple sessions. Future studies should develop feasible, effective, and less labor-intensive interventions, such as self-help manuals, telehealth interventions, or interventions delivered during routine visits.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 358-359
Author(s):  
Mary Grace Asirot ◽  
Anna Papazyan ◽  
Yeonsu Song

Abstract Traditionally, caregiving for individuals with dementia has been viewed as a negative experience. Understanding positive aspect of caregiving and related factors is important to improve health among family caregivers. We analyzed baseline data from an ongoing dyadic sleep education trial for individuals with dementia and their caregivers (N=21 dyads; mean age 70.8± 11.1 for caregivers, 80.5± 8.3 for care-recipients). The Positive Aspects of Caregiving (PAC 9-item) was used to assess subjective satisfaction with caregiving. Other measures included Zarit Burden Interview (ZBI), SF-12 Health Survey (SF-12v2), Revised Memory and Behavior Problems Checklist (RMBPC), and Pittsburgh Sleep Quality Index (PSQI). Pearson correlations and t-tests were calculated for analyses. Caregivers most frequently endorsed that caregiving enabled them to appreciate life more (n=16 agreed a lot). Caregivers who began providing care within the first few months of the care-recipient needing care (n=16) had greater positive aspects of caregiving than those who started providing care sometime later (n=5) (36.37±7.33 versus 25.8±8.29, p=0.01). Caregivers with higher PAC scores had lower ZBI score (r=-0.49, p=0.02), better mental health on the SF-12v2 (r=0.53, p=0.01), less distress related to care-recipient behaviors on the RMBPC (r=-0.50, p=0.02), and lower PSQI subscale (perceived sleep quality) score (r= -0.46, p=0.04). Findings suggest that higher positive caregiving experience was associated with better mental health and sleep quality, and less burden and distress from the care-recipients behaviors. More research is needed to better understand this relationship and to determine possible interventions to increase positive aspects of caregiving.


Dementia ◽  
2018 ◽  
Vol 19 (3) ◽  
pp. 590-605 ◽  
Author(s):  
Courtney A Polenick ◽  
Laura M Struble ◽  
Barbara Stanislawski ◽  
Molly Turnwald ◽  
Brianna Broderick ◽  
...  

Background and objectives Behavioral and psychological symptoms of dementia are highly prevalent, stressful, and challenging to manage. Caregivers’ approaches for handling these behaviors have implications for both care partners’ well-being. Yet the specific strategies that caregivers use in their daily management of behavioral and psychological symptoms of dementia are relatively unknown. This study used in-depth focus group data to examine family caregivers’ strategies for managing behavioral and psychological symptoms of dementia. Design As part of a larger study (NINR R01NR014200), four focus groups were conducted with a total of 26 family caregivers of older adults with dementia. Caregivers were asked to describe the strategies they use to manage behavioral and psychological symptoms of dementia. Data from audio-recorded sessions were transcribed, coded to identify relevant concepts, and reduced to determine major categories. Results Caregivers managed behavioral and psychological symptoms of dementia through (1) modifying interactions within the care dyad (e.g., simplifying communication); (2) modifying the care environment (e.g., using written prompts); (3) activity engagement; (4) humor; (5) self-care; and (6) social support. Conclusion Family caregivers manage behavioral and psychological symptoms of dementia using strategies to minimize stress and address the needs of both care partners. Caregivers’ own accounts of these approaches reveal a window into their everyday management of difficult behaviors. The present findings generate key information for routine clinical care and targeted interventions to promote caregiver well-being.


2016 ◽  
Vol 34 (1) ◽  
pp. 67-87 ◽  
Author(s):  
Patrick Barrett ◽  
Mary Butler ◽  
Beatrice Hale

The abstract consideration of ethical questions in family and informal caregiving might rightly be criticized for ignoring the lived experience of people. This chapter seeks to avoid such oversight by reflecting on ethical issues in family care in a way that is based on careful social scientific inquiry into the well-being of caregivers. The chapter draws on our research and experience in working with family caregivers, both professionally and personally. We step back from a practical concern with policies to support the well-being of caregivers to consider ethical issues associated with their typically hidden role. The chapter begins by noting the growing reliance on family care today. It proceeds to outline the dynamic experience of moving into and out of the caregiver role, before discussing key ethical issues associated with family care. Many of these stem from the risk that caregivers can come to share in the reduced circumstances and vulnerability of those for whom they care. Critical ethical issues are related to the typically "unboundaried" responsibility of family caregivers for the well-being of the cared-for person, something that can be contrasted with the more boundaried and intermittent responsibility of formal caregivers. Additionally, all too often, family caregivers encounter situations where their responsibilities exceed their capacities, but where a choice to not provide care will result in harm to the cared-for person. In discussing these issues, this chapter seeks to make the case for developing more responsive forms of support that promote positive benefits for both caregivers and care recipients.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S288-S288
Author(s):  
Victoria Steiner ◽  
Linda Pierce ◽  
Carol Bryan

Abstract Family caregiving is an essential, yet understudied, factor that can hasten, delay, or prevent hospital readmissions in individuals with cognitive deficits. This 3-month feasibility study examined 18 Internet-based educational CARREs (Communicate, Assist, Recognize & Report Events) Modules for family caregivers that address care recipients’ potentially avoidable hospitalization (PAH) conditions, e.g. UTI. This study determined: 1) caregivers’ perceptions about the use of the CARREs Modules, 2) caregivers’ self-reported value of the Modules, and 3) potential outcomes for caregivers and care recipients. Community-dwelling family caregivers were recruited from local support/education programs and assigned 6-8 Modules based on their care recipients’ needs. Links to online surveys were emailed at baseline, and 30 and 90 days post-enrollment. Descriptive statistics were performed on these data. Twenty potential subjects were screened but five were ineligible and three refused to participate. The remaining 12 subjects were primarily White females caring for a husband or parent. Subjects completed all the Modules they were assigned and did not experience any difficulties answering the survey questions. Subjects reported completing the Modules at least moderately increased their knowledge (67%), not being burdened by completing the Modules (67%), and very likely to participate again (58%). Many subjects stated the Modules taught them new things about preventing hospital readmissions in their care recipient (75%) and improved their well-being as a caregiver (83%). In collaboration with a home care agency, the investigators plan to implement and test a sustainable, “real-world” educational intervention incorporating the CARREs Modules that reaches a wide audience of family caregivers.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 351-352
Author(s):  
Hiroko Umegaki-Costantini

Abstract Despite substantial discussions on caregivers in policy making and academic research, a rapidly emerging new group of middle-aged male family caregivers who often also work are largely understudied. Inadequate understanding of male family caregivers jeopardises not only themselves but also care recipients, other family members and society: better care for older people depends on caregivers’ well-being. I address this gap by understanding how and why gender affects male family carers’ choices of care practices, and how male caregivers as ‘gendered beings’ sustain their well-being while reconciling work and care for their parents. Through in-depth-qualitative narrative interviews based on social anthropology of everyday life with 23 male working family carers in Tokyo in 2019, I find that men select care practices with priority given to familiar tasks deemed appropriately masculine. To perform ‘appropriate’ care for their parents, such men tend to approach care as they do their ‘work’: they ‘work-nise’ care. Such a gendered approach to care practices has important implications for addressing gender in public interventions. Also, I find that for male family working carers, achieving well-being does not mean balance in work, care and family. Rather, for them a source of well-being is from fulfilling filial duty as sons, which, however, requires making an appropriate effort and devoting themselves to some extent to support their parent(s). Thus, such men need to be embedded in a care and employment system that enables them to achieve such well being that, in turn, significantly impacts their care provision.


GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 115-125 ◽  
Author(s):  
Gabriele Wilz ◽  
Denise Schinköthe ◽  
Renate Soellner

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.


2020 ◽  
Author(s):  
Julia Hegy ◽  
Noemi Anja Brog ◽  
Thomas Berger ◽  
Hansjoerg Znoj

BACKGROUND Accidents and the resulting injuries are one of the world’s biggest health care issues often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT aims to remedy this situation by offering a low-threshold web-based self-help intervention for psychological distress after an accident. OBJECTIVE The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only care as usual. Furthermore, the program’s user friendliness, acceptance and adherence are assessed. We expect that the use of SelFIT is associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. METHODS Adults (n=240) showing adjustment problems due to an accident they experienced between 2 weeks and 2 years before entering the study will be randomized. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24 and 36 weeks). The main outcome is a reduction in anxiety, depression and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption and productivity loss as well as the program’s adherence, acceptance and user-friendliness. RESULTS Recruitment started in December 2019 and is ongoing. CONCLUSIONS To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offer of secondary and tertiary psychological prevention after an accident. CLINICALTRIAL ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912?cond=NCT03785912&draw=2&rank=1


Author(s):  
Pramila Kalaga ◽  
Barbara Wolford ◽  
Matthew Mormino ◽  
Timothy Kingston ◽  
Julie Fedderson ◽  
...  

The risk of a needle stick or sharps injury in the operating room (OR) is high due to conditions such as minimal physical protective measures, frequent transfer of sharps, and reliance on human attention and skill for injury avoidance. An ergonomic process improvement project was initiated at a large metro teaching hospital to identify ergonomic risk factors for these OR injuries. To maximize the engagement of the front- end users, an ergonomic process improvement (EPI) team was developed, consisting of representatives from participating OR teams, an employee health nurse and two ergonomists. Surveys, observations, and interviews were conducted to quantify injury risk for the OR teams, evaluate barriers to best practice adherence, and identify opportunities for targeted interventions. Risk mapping was completed for the surgeons, surgical techs and OR nurses identifying double gloving and safe passing zone as areas in need of improvement. Through observation and interviews, researchers identified physical factors relating to musculoskeletal pain and cognitive factors leading to distractions as safety risk concerns. The overall success of the EPI was the engagement of the OR teams and surgeons in the process of identifying risk factors and potential opportunities for ergonomic solutions related to cognitive workload, physical workload, teamwork, and work design for injury prevention. The risk factors identified will provide the basis for developing targeted, effective interventions for eliminating injuries from needles and sharps within the OR.


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