scholarly journals Comprehensive Assessment of Triggers for Behaviours of Concern Scale (CATS): Initial Development

2021 ◽  
Vol 18 (20) ◽  
pp. 10674
Author(s):  
Bharati Limbu ◽  
Gemma Unwin ◽  
Shoumitro (Shoumi) Deb
Keyword(s):  
Family Caregivers ◽  
Comprehensive Assessment ◽  
Challenging Behaviour ◽  
Initial Development ◽  
Comprehensive Literature Review ◽  
The Family ◽  
People With Intellectual Disabilities ◽  
Positive Behaviour Support ◽  
Stage 1 ◽  
Two Stages

Challenging behaviour displayed by people with intellectual disabilities (ID) can be difficult to manage if caregivers do not understand the reasons for the behaviour. Identifying the contextual variables/triggers for the behaviour is likely to help undertake a functional analysis leading to a person-centred positive behaviour support plan. Currently, a limited number of checklists are available for trigger assessment and none were developed using an interview with the family caregivers. This article describes the development and contents of the comprehensive assessment of triggers for behaviours of concern scale (CATS). CATS was developed in two stages. Stage 1 used a ‘bottom-up’ approach, in which caregivers of adults with ID who show aggressive behaviour were interviewed to identify the triggers for aggression. In stage two, using a ‘top-down’ approach, a comprehensive literature review was conducted to gather items from existing trigger checklists. Trigger items from both stages were combined and the duplicates were removed. The final list in CATS consists of 333 contextual triggers categorised under five main domains and 12 subdomains. CATS can be used by caregivers to identify triggers or antecedents of challenging behaviour. Further work is needed to test its psychometric properties, utility, and acceptability.

Complex Behaviour Service: enhanced model for challenging behaviour

2014 ◽  
Vol 8 (4) ◽  
pp. 219-227 ◽  
Author(s):  
Sophie Inchley-Mort ◽  
Khadija Rantell ◽  
Charlotte Wahlich ◽  
Angela Hassiotis
Keyword(s):  
Usual Care ◽  
Group Differences ◽  
Challenging Behaviour ◽  
Mental Health Needs ◽  
Complex Behaviour ◽  
Content Type ◽  
Clinical Benefits ◽  
People With Intellectual Disabilities ◽  
Positive Behaviour Support ◽  
Challenging Behaviours

Purpose – Positive Behaviour Support (PBS) is thought to be an important model for working with people with intellectual disabilities who display behaviours challenging to service. The purpose of this paper is to explore clinical and service user outcomes associated with the delivery of PBS by a Complex Behaviour Service (CBS). Design/methodology/approach – Clinical outcomes of 24 service users treated by the CBS team were assessed at baseline, six and 12 months and compared with those of 22 peers who received usual care. The main outcome was reduction in challenging behaviour measured by the Aberrant Behaviour Checklist (ABC). Secondary outcomes included measures of mental health needs, risk and social care supports. Findings – At six months improvements were seen across all ABC domains in both groups, with greater improvement in the CBS group, compared to usual care in irritability and stereotypy. Between group differences were maintained only for stereotypy at 12 months. No other differences were found. Originality/value – This paper suggests that PBS delivered by trained and dedicated staff may provide clinical benefits to individuals with challenging behaviours. However, there are issues around integration into existing services that need to be addressed in order to maximise efficiency.

scholarly journals The perception of family caregivers regarding the changes that occur after the diagnosis of dementia

2018 ◽  
Vol 21 (6) ◽  
pp. 743-754
Author(s):  
Luciana Maria Santos Cesário ◽  
Isabelle Patriciá Freitas Soares Chariglione
Keyword(s):  
Family Caregivers ◽  
Hierarchical Classification ◽  
The Elderly ◽  
Current Time ◽  
The Family ◽  
Geriatric Clinic ◽  
Diagnosis Of Dementia ◽  
Family Routine ◽  
Spss Software ◽  
Two Stages

Abstract Objectives : to identify the perceptions of family caregivers regarding the changes that occurred in the family after an elderly relative received a diagnosis of dementia, measuring the changes in the level of burden and analyzing the discourse of such caregivers. Method : the research was conducted through an interview and sociodemographic questionnaire, in addition to the application of a scale that measures caregiver burden, the Zarit Burden Interview. These procedures were applied in two stages, in the multidisciplinary reception of a geriatric clinic, and after three months of care. For the qualitative analysis, the IRaMuTeQ software was used, where, in the first stage, the results were as follows: in the Descending Hierarchical Classification (DHC) four classes were identified: Time (25.00%), Knowledge (33.00%), Consequences and Causes (19.40%); In the Word Cloud (WC), the word ‘No” prevailed. In the second stage, DHC presented six classes, Current Time (13.70%), General Causes (15.70%), Future Time (13.70%), Actions (17.60%), Consequences (23.50%) and Immediate Causes (15.70%). The WC continued to refer most frequently to the word ‘No’. For quantitative analyzes, the SPSS software was used. Results : in most cases, the profile of caregivers was women (75.00%), wives (62.00%), primary caregivers (87.50%), and the elderly (60-75 years). The assessment of burden was moderate to severe (75.00%). Conclusion : caring for a relative with a diagnosis of dementia has direct implications for family caregivers, especially family caregivers facing the aging process. The demands of caring modify the family routine and greatly increase the burden of caregivers.

Managing Caregiver Burden among Families of Patients with End-Stage Renal Disease

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemisi Okikiade Oyegbile ◽  
Petra Brysiewicz
Keyword(s):  
Renal Disease ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
End Stage Renal Disease ◽  
Qualitative Data ◽  
Government Support ◽  
Implementation Phase ◽  
The Family ◽  
Stage Renal Disease ◽  
End Stage

Family caregivers of patients with end-stage renal disease (ESRD) play a significant role in providing substantial care for a prolonged period for their sick relatives, often with very limited resources, making it a difficult environment. Government support for family caregivers of patients with ESRD is lacking in Nigeria, increasing their vulnerability to caregiver burden and its consequences. An action research study using a complimentary mixed-method approach was used to develop the intervention model for managing caregiver burden. Quantitative data were collected to measure the extent of caregiver burden using a Zarit Burden Interview questionnaire for 96 family caregivers, while individual in-depth interviews with 15 participants provided the qualitative data. Integrating the quantitative and qualitative data led to the identification of four moderators to manage the caregiver burden in this study. The model for managing caregiver burden was developed from the findings, using stressors and associated moderators of caregiving, and the role played by culture and finance in this context. An implementation checklist was developed, which was used by registered nurses to implement the concepts in the model with the family caregivers during the model implementation phase. Family caregivers of patients with ESRD need to be supported by nurses during the caregiving process. Nurses can increase caregivers’ identity and knowledge of the disease as a way of preventing the family caregivers from being overwhelmed by their caregiving role.

scholarly journals Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties

2020 ◽  
pp. bmjspcare-2020-002608
Author(s):  
Joaquín T Limonero ◽  
Jorge Maté-Méndez ◽  
María José Gómez-Romero ◽  
Dolors Mateo-Ortega ◽  
Jesús González-Barboteo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
End Of Life ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Family Caregiver ◽  
Screening Tools ◽  
Anxiety And Depression ◽  
The Family ◽  
End Stage

BackgroundFamily caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools.AimThis study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC).DesignMulticentre, cross-sectional study.Settings/participantsFamily caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA).Results138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach’s alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale.ConclusionsThe DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

Protective preparation: a process central to family caregivers of persons with mild cognitive impairment

2017 ◽  
Vol 30 (3) ◽  
pp. 375-384 ◽  
Author(s):  
Ching-Lin Wang ◽  
Li-Min Kuo ◽  
Yi-Chen Chiu ◽  
Hsiu-Li Huang ◽  
Huei-Ling Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Family Caregiving ◽  
Healthcare Providers ◽  
Theory Approach ◽  
Face To Face ◽  
The Family ◽  
The Impact

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.

scholarly journals Effect of 2CaO·SiO2 particles addition on dephosphorization behavior

2020 ◽  
Vol 39 (1) ◽  
pp. 219-227
Author(s):  
Aijun Deng ◽  
Yunjin Xia ◽  
Jie Li ◽  
Dingdong Fan
Keyword(s):  
Liquid Slag ◽  
Solid Phase ◽  
Solid Particles ◽  
Hot Metal ◽  
Liquid Silicate ◽  
Phase Complex ◽  
Dephosphorization Slag ◽  
Stage 1 ◽  
Two Stages ◽  
Complex Liquid

AbstractThe effect of the addition of 2CaO·SiO2 solid particles on dephosphorization behavior in carbon-saturated hot metal was investigated. The research results showed that the addition of 2CaO·SiO2 particles have little influence on desilication and demanganization, and the removal of [Si] and [Mn] occurred in the first 5 min with different conditions where the contents of 2CaO·SiO2 particles addition for the conditions 1, 2, 3, 4, and 5 are 0, 2.2, 6.4, 8.6, and 13.0 g, respectively. The final dephosphorization ratios for the conditions 1, 2, 3, 4, and 5 are 61.2%, 66.9%, 79.6%, 63.0%, and 78.1%, respectively. The dephosphorization ratio decreases with the increase of 2CaO·SiO2 particles in the first 3 min. The reason for this is that the dephosphorization process between hot metal and slag containing C2S phase consisted of two stages: Stage 1, [P] transfers from hot metal to liquid slag and Stage 2, the dephosphorization production (3CaO·P2O5) in liquid slag reacts with 2CaO·SiO2 to form C2S–C3P solid solution. The increase of 2CaO·SiO2 particles increases the viscosity of slag and weakens the dephosphorization ability of the stage 1. The SEM and XRD analyses show that the phase of dephosphorization slag with the addition of different 2CaO·SiO2 particles is composed of white RO phase, complex liquid silicate phase, and black solid phase (C2S or C2S–C3P). Because the contents of C2S–C3P and 2CaO·SiO2 in slag and the dephosphorization ability of the two stages are different, the dephosphorization ability with different conditions is different.

Effectiveness of a Primary Care Program to Increase Physical Activity in People With Dementia and Their Family Caregivers (AFISDEMYF Study).

2021 ◽  
Author(s):  
Elena DE DIOS-RODRIGUEZ ◽  
María C PATINO-ALONSO ◽  
Susana GONZÁLEZ-SÁNCHEZ ◽  
Joana RIPOLL ◽  
Olaya TAMAYO-MORALES ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Primary Care ◽  
Systolic Blood Pressure ◽  
Family Caregivers ◽  
Intervention Group ◽  
Care Program ◽  
Control Group ◽  
People With Dementia ◽  
The Family

Abstract Aim: To evaluate the effectiveness of an intervention in primary health care designed to increase physical activity in people with dementia and their family caregivers.Methods: A cluster-randomized multicentre clinical trial was carried out.Participants: 140 people with dementia (median age 82 years;63.6% women) and 176 caregivers (median age 62 years ;72.7% women). Seventy patients and 80 caregivers were assigned to the Control Group (CG) and 70 patients and 96 caregivers to the Intervention Group (IG). The physical activity was measured with the pedometer and with the IPAQ-SF questionnaire. The intervention consisted of applying in primary care the program promoting physical activity (PEPAF) for 3 months. The changes observed at 6 months were analyzed. Results:In people with dementia, in the pedometer assessment a decrease was observed in both groups, but it was larger in the CG both in the total number step/day lower in the IG than in the CG and in the aerobic steps / day (52.89 vs -615.93). The activity reported with the IPAQ-SF decreased more in IG, both in the MET/min/week (-258.470 vs -148.23) and in the MVPA min/week. In caregivers the pedometer assessment showed that total steps/day increased more in the IG, as did aerobic steps/day (356.91 vs -12.95). The IPAQ-SF a smaller increase in global activity was declared in the IG than in the CG (545.25 MET/min/week vs 609.55), but the increase in vigorous activity was greater. No differences were found in changes in the functional status and the cognitive performances of people with dementia nor in the mental health in the caregivers, but systolic blood pressure, the Family APGAR and overload in the IG did improve.Conclusions: The results suggest that the intervention carried out may be effective on physical activity in both patients and caregivers. It can also improve systolic blood pressure, the Family APGAR and overload in caregivers. This is the first study to implement a primary care intervention aimed at simultaneously increasing physical activity in people with dementia and their relatives. These results reinforce the importance of using objective measures in clinical trials in people with dementia.Trial registration number: NCT 02044887.

Commentary on “A family’s battle to understand ‘challenging behaviour’”

2017 ◽  
Vol 22 (2) ◽  
pp. 105-108
Author(s):  
Joann Kiernan
Keyword(s):  
Intellectual Disabilities ◽  
Design Methodology ◽  
Local Communities ◽  
Challenging Behaviour ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Individuals With Intellectual Disabilities

Purpose The purpose of this paper is to provide a commentary on issues raised in the paper “A family’s battle to understand ‘challenging behaviour’”. Design/methodology/approach Drawing on literature associated with issues identified in the paper this commentary will reflect on the evidence associated with providing specialist support to people with intellectual disabilities and challenging behaviour. Findings Families, individuals and services are unable to access timely and appropriate specialist support for individuals with intellectual disabilities and challenging behaviour. As individuals go on to develop behaviours associated with a lack of intervention their levels of vulnerability increase due to their exclusion from services and their local communities. Originality/value The commentary provides a discussion on the issues faced by individuals and their families in relation to intellectual disabilities and challenging behaviour.

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