A Systematic Review of Caregiver Burden following Stroke

Caregiver burden following stroke is increasingly recognised as a significant health care concern. A growing number of studies have evaluated the patient, caregiver, and social support factors that contribute to increased caregiver burden. We conducted a systematic review of this literature to guide future research. A search of the MEDLINE, PsyclNFO, CINAHL, and EMBASE databases (up to July 2008) and reference sections of published studies using a structured search strategy yielded 24 relevant articles. Studies were included if they evaluated predictors and/or correlates of caregiver burden in the setting of stroke. The prevalence of caregiver burden was 25–54% and remained elevated for an indefinite period following stroke. In studies that evaluated independent baseline predictors of subsequent caregiver burden, none of the factors reported were consistent across studies. In studies that assessed concurrent factors independently contributing to caregiver burden in the poststroke period, patient characteristics and social support factors were inconsistently reported. Several studies identified caregiver mental health and the amount of time and effort required of the caregiver as significant determinants of caregiver burden. Our findings highlight the need for more research to identify caregivers in need of support and guide the development and implementation of appropriate interventions to offset caregiver burden.

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A Systematic Review of Amenable Resilience Factors that Moderate and/or Mediate the Relationship between Childhood Adversity and Mental Health in Young People

10.31219/osf.io/bkyax ◽

2017 ◽

Author(s):

Jessica Fritz ◽

Anne de Graaff ◽

Helen Caisley ◽

Anne-Laura Van Harmelen ◽

Paul O. Wilkinson

Keyword(s):

Mental Health ◽

Social Support ◽

Systematic Review ◽

Young People ◽

Empirical Support ◽

Childhood Adversity ◽

Future Research ◽

Increased Risk ◽

Resilience Factors ◽

The Relationship

THIS IS A PRE-PRINT OF AN ARTICLE PUBLISHED IN "FRONTIERS IN PSYCHIATRY - SPECIAL ISSUE: RESILIENCE, LIFE EVENTS, TRAJECTORIES AND THE BRAIN (9: 230)". THE FINAL AUTHENTICATED VERSION IS AVAILABLE ONLINE AT: https://doi.org/10.3389/fpsyt.2018.00230Background: Up to half of Western children and adolescents experience at least one type of childhood adversity. Individuals with a history of childhood adversity have an increased risk of psychopathology. Resilience enhancing factors reduce the risk of psychopathology following childhood adversity. A comprehensive overview of empirically supported resilience factors is critically important for interventions aimed to increase resilience in young people. Moreover, such an overview may aid the development of novel resilience theories. Therefore, we conducted the first systematic review of social, emotional, cognitive and/ or behavioural resilience factors after childhood adversity.Methods: We systematically searched Web of Science, PsycINFO and Scopus (e.g. including MEDLINE) for English, Dutch and German literature. We included cohort studies that examined whether a resilience factor was a moderator and/ or a mediator for the relationship between childhood adversity and psychopathology in young people (mean age 13-24). Therefore, studies were included if the resilience factor was assessed prior to psychopathology, and childhood adversity was assessed no later than the resilience factor. Study data extraction was based on the STROBE report and study quality was assessed with an adapted version of Downs and Black’s scale. The preregistered protocol can be found at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016051978.Results: The search identified 1969 studies, of which 22 were included (eight nationalities, study sample n range: 59-6780). We found empirical support for 13 of 25 individual-level (e.g. high self-esteem, low rumination), six of 12 family-level (e.g. high family cohesion, high parental involvement), and one of five community-level resilience factors (i.e. high social support), to benefit mental health in young people exposed to childhood adversity. Single versus multiple resilience factor models supported the notion that resilience factors should not be studied in isolation, and that interrelations between resilience factors should be taken into account when predicting psychopathology after childhood adversity.Conclusions: Interventions that improve individual, family, and/ or social support resilience factors may reduce the risk of psychopathology following childhood adversity. Future research should scrutinize whether resilience factors function as a complex interrelated system that benefits mental health resilience after childhood adversity.

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Is social support related to better mental health, treatment continuation and success rates among individuals undergoing in-vitro fertilization? Systematic review and meta-analysis protocol

PLoS ONE ◽

10.1371/journal.pone.0252492 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252492

Author(s):

Marisa Casale ◽

Anna Carlqvist

Keyword(s):

Mental Health ◽

Social Support ◽

Systematic Review ◽

In Vitro Fertilization ◽

Future Research ◽

Qualitative Synthesis ◽

Positive Health ◽

Psychological Burden ◽

Vitro Fertilization

Infertility and its treatment via in-vitro fertilization (IVF) represent a global health area of increasing importance. However, the physical and psychological burden of IVF can negatively impact psychological wellbeing, as well as treatment retention and success. Social support has been found to have positive health effects among populations facing health-related stressors worldwide, and its potential protective role for IVF patients merits further attention. We present a protocol for a systematic review of peer-reviewed published studies quantitatively investigating associations between social support and i) mental health; ii) the decision to (dis)continue with IVF treatment cycles and; iii) IVF success (pregnancy and birth rates); among individuals who are undertaking or have undertaken IVF cycles. Studies will be included if they work with human subjects, provide correlation coefficients between measures of social support and at least one of the outcomes of interest, and are in the English language. Social support may derive from both naturally occurring networks and more formalized sources or interventions. The protocol for this systematic review was developed according to the PRISMA-P guidelines. Ten health-, psychology- and sociology-related databases will be searched using composite search terms that include keywords for ‘IVF’ and ‘social support’. To assess methodological quality, the authors will use a modified version of the Newcastle-Ottawa Scale. Should three or more moderate or good quality studies be identified for any one outcome of interest, correlation meta-analyses, using the Hedges-Olkin method, will be conducted to pool effect sizes and heterogeneity will be assessed. Should the number, quality and characteristics of eligible studies not allow for reliable quantitative synthesis, the authors will limit the analysis to qualitative synthesis, with a focus on implications of findings for future research and programming.

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Epidemiology of Depression and Anxiety in Gout: A Systematic Review and Metaanalysis

The Journal of Rheumatology ◽

10.3899/jrheum.190974 ◽

2020 ◽

Vol 48 (1) ◽

pp. 129-137 ◽

Cited By ~ 1

Author(s):

Alyssa Howren ◽

Drew Bowie ◽

Hyon K. Choi ◽

Sharan K. Rai ◽

Mary A. De Vera

Keyword(s):

Mental Health ◽

Systematic Review ◽

Search Strategy ◽

Positive Association ◽

Future Research ◽

Depression And Anxiety ◽

Inclusion Criteria ◽

Random Effects Models ◽

Cochrane Database ◽

Epidemiology Of Depression

Objective.To conduct a systematic review of depression and anxiety among patients with gout that specifically evaluates the prevalence, incidence, determinants, and effects of these mental health comorbidities.Methods.We conducted a literature search in Medline, Embase, Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO using indexed terms and key words to identify studies reporting on depression/anxiety in patients with gout. This review included full-text articles published in English that reported on patients with gout, evaluated depression/anxiety using a routinely reported measure, and provided estimates or sufficient data on the prevalence, incidence, determinants, or effects of depression/anxiety. Metaanalyses were conducted using random effects models.Results.Twenty of 901 articles identified through the search strategy met our inclusion criteria. All 20 studies evaluated depression, while only 10 assessed anxiety (50%). Metaanalyses suggest a positive association between mental health disorders and gout, as resultant pooled OR were 1.29 (95% CI 1.07–1.56) for depression and 1.29 (95% CI 0.96–1.73) for anxiety. Findings from four studies reporting on the incidence of depression in patients with gout resulted in a pooled HR of 1.17 (95% CI 1.01–1.36). Significant determinants of depression included number of tophi, frequency of flares, and oligo/polyarticular gout.Conclusion.Our systematic review suggests that depression and anxiety are significantly associated with gout, highlighting the need for future research to focus on the onset of mental disorders after gout diagnosis. We also identify potential targets for intervention.

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Determinants of overburdening among informal carers: A systematic review

10.21203/rs.2.12116/v1 ◽

2019 ◽

Author(s):

Nienke Lindt ◽

Jantien van Berkel ◽

Bob Mulder

Keyword(s):

Social Support ◽

Systematic Review ◽

Informal Care ◽

Caregiver Burden ◽

Behavioral Problems ◽

Role Expectations ◽

Cognitive Capacity ◽

Future Research ◽

Informal Carers ◽

Design And Methods

Abstract Background and Objective: The Dutch population is ageing, resulting in rising care demands and healthcare costs, which in turn led to a shift from formal to informal care. However, not only is the number of potential informal carers fastly decreasing, informal caregivers also experience higher caregiver burden. This literature review aimed at identifying the determinants of caregiver burden, to inform future interventions and foster informal care activities. Research Design and Methods: A systematic review of peer-reviewed articles included in either PubMed, Scopus and/or PsychInfo has been conducted. Results: 17 articles have been included. The most important predictors were the duration of caregiving and the dependency level of the patient, both in terms of physical dependency and mental dependency stemming from decreased cognitive capacity or behavioral problems. Some specific illnesses and role conflicts or captivity also increased burden, while social support lowered it. Being a female caregiver or having an adult-childrelationhip led to higher burden. Discussion and Implications: Firstly, it is recommended that specific interventions are designed for carers most at risk and that they focus on increasing the patient’s physical and mental independency. Moreover, interventions need to be adapted to the illness trajectory of specific diseases and the adhering needs for social support of both the recipient and caregiver. Lastly, role expectations should be changed, leading to men being more involved. Future research could focus on determining causality, the concept of ‘time’ and the relevance of cultural expectations.

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Tri-Response Police, Ambulance, Mental Health Crisis Models in Reducing Involuntary Detentions of Mentally Ill People: Protocol for a Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158230 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8230

Author(s):

Julia Heffernan ◽

Ewan McDonald ◽

Elizabeth Hughes ◽

Richard Gray

Keyword(s):

Mental Health ◽

Systematic Review ◽

Assessment Tool ◽

Public Health Practice ◽

Grey Literature ◽

Risk Of Bias ◽

Future Research ◽

Mental Health Crisis ◽

Health Crisis ◽

Response Models

Police, ambulance and mental health tri-response services are a relatively new model of responding to people experiencing mental health crisis in the community, but limited evidence exists examining their efficacy. To date there have been no systematic reviews that have examined the association between the tri-response model and rates of involuntary detentions. A systematic review examining co-response models demonstrated possible reduction in involuntary detention, however, recommended further research. The aim of this protocol is to describe how we will systematically review the evidence base around the relationship of the police, ambulance mental health tri-response models in reducing involuntary detentions. We will search health, policing and grey literature databases and include clinical evaluations of any design. Risk of bias will be determined using the Effective Public Health Practice Project Quality Assessment Tool and a narrative synthesis will be undertaken to synthesis key themes. Risk of bias and extracted data will be summarized in tables and results synthesis tabulated to identify patterns within the included studies. The findings will inform future research into the effectiveness of tri-response police, ambulance, and mental health models in reducing involuntary detentions.

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Stress and burnout in Improving Access to Psychological Therapies (IAPT) trainees: a systematic review

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x21000179 ◽

2021 ◽

Vol 14 ◽

Author(s):

Joel Owen ◽

Louise Crouch-Read ◽

Matthew Smith ◽

Paul Fisher

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Health Professionals ◽

Health Professionals ◽

Future Research ◽

List Type ◽

Dual Roles ◽

Eligibility Criteria ◽

Psychological Therapies ◽

Current State

Abstract For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given. Key learning aims (1) To establish the current state of the literature regarding stress and burnout in IAPT trainees. (2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees. (3) To make recommendations regarding future research on the topic.

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The Acceptability and Usability of Digital Health Interventions for Adults With Depression, Anxiety, and Somatoform Disorders: Qualitative Systematic Review and Meta-Synthesis

Journal of Medical Internet Research ◽

10.2196/16228 ◽

2020 ◽

Vol 22 (7) ◽

pp. e16228 ◽

Cited By ~ 1

Author(s):

Shireen Patel ◽

Athfah Akhtar ◽

Sam Malins ◽

Nicola Wright ◽

Emma Rowley ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Somatoform Disorders ◽

Digital Health ◽

Health Interventions ◽

Health Conditions ◽

Future Research ◽

World Population ◽

Personal Support ◽

The Individual

Background The prevalence of mental health disorders continues to rise, with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence, only one-third of people with depression or anxiety receive treatment. Over the last decade, the use of digital health interventions (DHIs) has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of DHIs for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved. Objective This systematic review aimed to identify, appraise, and synthesize the qualitative literature available on service users’ views and experiences regarding the acceptability and usability of DHIs for depression, anxiety, and somatoform disorders. Methods A systematic search strategy was developed, and searches were run in 7 electronic databases. Qualitative and mixed methods studies published in English were included. A meta-synthesis was used to interpret and synthesize the findings from the included studies. Results A total of 24 studies were included in the meta-synthesis, and 3 key themes emerged with descriptive subthemes. The 3 key themes were initial motivations and approaches to DHIs, personalization of treatment, and the value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of the success of DHIs. The main reason for this was the way it enabled individual personalization of care. Conclusions Findings from the systematic review have implications for the design of future DHIs to improve uptake, retention, and outcomes in DHIs for depression, anxiety, and somatoform disorders. DHIs need to be personalized to the specific needs of the individual. Future research should explore whether the findings could be generalized to other health conditions.

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Abstract 14087: Psychosocial Determinants of Health Predict Depressive Symptoms and Anxiety in Rural Caregivers

Circulation ◽

10.1161/circ.142.suppl_3.14087 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jennifer L Smith ◽

Misook L Chung ◽

Jennifer Miller ◽

Martha J Biddle ◽

Donna Schuman ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Caregiver Burden ◽

Perceived Stress ◽

Brief Symptom Inventory ◽

Determinants Of Health ◽

Future Research ◽

Cvd Risk ◽

Rural Caregivers ◽

Increased Risk

Introduction: Caregivers have an 82% increased risk of cardiovascular disease (CVD) compared to non-caregivers. Depressive symptoms (DS) and anxiety increase CVD risk, and these are worse in rural dwellers. Knowing predictors of DS and anxiety in rural caregivers of patients with chronic illness is important to reduce CVD risk. Purpose: To identify predictors of DS and anxiety in rural caregivers at risk for CVD using a social determinants of health (SDH) model. Method: In this cross-sectional study we measured multiple SDH. These variables included sociodemographic (i.e., age, gender, race, marital status, health insurance, education, financial status), behavioral (i.e., smoking and body mass index [BMI]), and psychosocial (i.e., caregiver burden measured by the Zarit Burden Interview, perceived stress by the Cohen Perceived Stress Scale, and social support by the Medical Outcomes Study Social Support Survey) factors. The outcomes of DS were measured by the Patient Health Questionnaire-9 and anxiety by the Brief Symptom Inventory – Anxiety subscale. Data were analyzed using two separate multiple regression models, one for DS and one for anxiety. As depression and anxiety are often comorbid, they were considered predictors in the appropriate models. Results: In the 262 participants (mean age 53±13, 78% female, 96% Caucasian, 70% were married), mean years of education were 14±2, 56.1% had enough money to make ends meet, and 55% had no insurance or Medicaid only. Significant predictors of worse DS were higher caregiver burden (β=0.05, p=0.004), higher perceived stress (β=2.04, p=0.001), and higher anxiety (β=3.79, p= <0.001). Predictors of worse anxiety, were younger age (β=-0.006, p=0.03), higher caregiver burden (β=0.006, p=0.009), lower social support (β=-0.004, p=0.05), and higher DS (β=0.08, p=<0.001). Conclusion: Predictors of DS and anxiety in these rural caregivers were psychosocial variables. Caregiver CVD Interventions could be optimized by including stress management, education about the psychological effects of caregiving, and social support components. Future research is needed on the role of DS and anxiety in CVD to better support rural caregivers at highest risk.

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The Imposter Phenomenon in the Medical Profession

Gender Equity in the Medical Profession - Advances in Medical Education, Research, and Ethics ◽

10.4018/978-1-5225-9599-1.ch011 ◽

2020 ◽

pp. 148-166

Author(s):

Rebecca C. Grossman

Keyword(s):

Mental Health ◽

Systematic Review ◽

Coping Strategies ◽

Ethnic Minorities ◽

Medical Profession ◽

Future Research ◽

Review Of The Literature ◽

Imposter Phenomenon ◽

Internal Experience ◽

The Impact

The imposter phenomenon, or imposter syndrome, is defined as an internal experience of feeling like an intellectual fraud, despite external evidence of an individual's accomplishments, and results in an inability to internalise a sense of success. It is common among high-achieving people, and appears to be more common in women and ethnic minorities. In this chapter, a systematic review of the literature will be presented on imposter syndrome in the medical profession. Topics covered include purported aetiology, implications (including the impact on mental health and career progression), limitations of research, potential coping strategies, and avenues for future research.

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