scholarly journals Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings: A Prospective Cohort Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12310
Author(s):  
Yen Sin Koh ◽  
Gerald Choon-Huat Koh ◽  
David Matchar ◽  
Song-Iee Hong ◽  
Bee Choo Tai
Keyword(s):  
Relative Risk ◽  
Social Interactions ◽  
Care Management ◽  
Management Strategies ◽  
Community Resources ◽  
Subjective Burden ◽  
Service Usage ◽  
Mixed Effect ◽  
Care Relationship ◽  
Objective Burden

Since the introduction of the integrated care model, understanding how social interactions and community resources can alleviate caregivers’ burden is vital to minimizing negative patients’ outcomes. This study (n = 214) examined the associations between these factors and caregivers’ burden in stroke settings. It used 3-month and 1-year post-stroke data collected from five tertiary hospitals. Subjective and objective caregivers’ burdens were measured using Zarit burden interview and Oberst caregiving burden scale respectively. The independent variables examined were quality of care relationship, care management strategies for managing patients’ behaviour, family caregiving conflict, formal service usage and assistance to the caregiver. Significant associations were determined using mixed effect modified Poisson regressions. For both types of burden, the scores were slightly higher at 3 months as compared to 1 year. Poorer care-relationship (relative risk: 0.81, 95% confidence interval (CI): 0.70–0.94) and adopting positive care management strategies (relative risk: 1.05, 95% CI: 1.02–1.07) were independently associated with a high subjective burden. Providing assistance to caregivers (relative risk: 2.45, 95% CI: 1.72–3.29) and adopting positive care management strategies (relative risk: 1.03, 95% CI: 1.02–1.04) were independently associated with a high objective burden. Adopting positive care management strategies at 3 months had a significant indirect effect (standardised β: 0.11, 95% CI: 0.01 to 0.20) on high objective burden at one year. Healthcare providers should be aware that excessive care management strategies and assistance from family members may add to caregivers’ burden.

scholarly journals Family burden in schizophrenia: the influence of age of onset and negative symptoms

2016 ◽  
Vol 38 (2) ◽  
pp. 96-99 ◽  
Author(s):  
Lucas M. Mantovani ◽  
Rodrigo Ferretjans ◽  
Iara M. Marçal ◽  
Amanda M. Oliveira ◽  
Fernanda C. Guimarães ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Age Of Onset ◽  
Linear Regression Analysis ◽  
Disease Onset ◽  
Family Burden ◽  
Positive Symptoms ◽  
Subjective Burden ◽  
Sociodemographic Variables ◽  
Objective Burden ◽  
Positive And Negative Symptoms

Abstract Objectives: To investigate the determinants of family burden in a sample of patients with schizophrenia and their caregivers. Methods: Thirty-one stable patients with schizophrenia and their main caregivers were recruited. Sociodemographic variables were assessed in a semi-structured interview, and positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed with the Schizophrenia Cognition Rating Scale (SCoRS). Levels of burden on caregivers were assessed with the Family Burden Interview Schedule (FBIS). Interactions among variables were analyzed using Pearson correlations and linear regression analysis. Results: Objective and subjective FBIS scores were 1.9 (standard deviation [SD] = 0.5) and 2.4 (SD = 0.6) respectively. Objective burden correlated positively with positive and negative symptoms, and cognitive impairment. Subjective burden correlated positively with positive symptoms and negatively with mean age of disease onset. Positive, negative and cognitive symptoms accounted for 47.6% of the variance of objective burden, with negative symptoms accounting independently for 30.3%. Age of onset, parents as caregivers and positive symptoms accounted for 28% of the variance of subjective burden, with age of onset independently explaining 20.3%. Conclusion: Patients' clinical and sociodemographic variables are important determinants of family burden in schizophrenia. Objective burden is predicted by symptoms, particularly negative ones. Subjective burden is predicted by symptoms and sociodemographic variables, particularly age of disease onset.

scholarly journals Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016

2018 ◽  
Vol 26 (2) ◽  
pp. 104-112
Author(s):  
Ming Li ◽  
David Roder ◽  
Lisa J Whop ◽  
Abbey Diaz ◽  
Peter D Baade ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Relative Risk ◽  
Confidence Interval ◽  
Cervical Screening ◽  
South Australia ◽  
Low Grade ◽  
High Grade ◽  
Mixed Effect ◽  
Aboriginal Women ◽  
Cytological Abnormality

Objective Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Methods Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Results Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Conclusions Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.

scholarly journals Beban Keluarga Pada Penderita Diabetes Melitus Tipe II

2018 ◽  
Vol 2 (1) ◽  
pp. 85
Author(s):  
I Ketut Alit Adianta ◽  
Gusti Ayu Wardianti
Keyword(s):  
Diabetes Mellitus ◽  
Family Burden ◽  
Type Ii ◽  
Subjective Burden ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
Heavy Burden ◽  
Objective Burden ◽  
Family Condition ◽  
Diabetes Melitus

ABSTRACTDiabetes mellitus (DM) is chronic disease characterized by blood glucose level high than normal. When one of family member suffers from illness, it will affect family condition in managing treatment and caring.This study aimed to identify family burden of patients with Type II DM in Puskesmas III of North Denpasar including objective, subjective, and iatrogenic burden. This study employed descriptive design with cross sectional approach. The study involved 102 respondents with consecutive sampling. Data were collected by questionnaire. Findings indicated that objective burden of family with mild, moderate, and heavy burden were 24.5%, 8.8% and  66.7%; respectively). Subjective burden indicating mild, moderate, and heavy burden were 6.9%, 70.6% and 22.5% respectively. Iatrogenic burden indicating mild, moderate, and heavy burden were 8.8%,  1% and 90.2% respectively. All families experienced heavy burden in caring for patients with DM because of difficulty in treatment.  Keywords: Objective Burden, Subjective Burden, Iatrogenic Burden, Diabetes Mellitus

scholarly journals Invasive alien palm Pinanga coronata threatens native tree ferns in an oceanic island rainforest

2018 ◽  
Vol 66 (8) ◽  
pp. 647 ◽  
Author(s):  
Michael J. B. Dyer ◽  
Gunnar Keppel ◽  
Marika Tuiwawa ◽  
Sainivalati Vido ◽  
Hans Juergen Boehmer
Keyword(s):  
Linear Models ◽  
Management Strategies ◽  
Ornamental Plants ◽  
Native Plant ◽  
Ecological Processes ◽  
Mixed Effect ◽  
Mixed Effect Models ◽  
Tree Ferns ◽  
Native Tree ◽  
Negative Impacts

Invasive ornamental plants are a global problem that can have severe impacts on native biodiversity, especially on islands. To determine whether the invasive, ornamental ivory-cane palm Pinanga coronata could be displacing native biodiversity, we investigated its co-distribution with native tree ferns in a Fijian rainforest. We recorded the abundances of P. coronata and tree ferns and related these to environmental variables using linear models and generalised linear mixed-effect models (GLMMs). Distance to an introduction site was the most significant factor predicting the palm’s distribution and abundance, suggesting that its current distribution is limited by insufficient time for wider dispersal. P. coronata cover was strongly and negatively related with the abundance of native tree ferns and the palm may therefore be displacing native tree ferns. This relationship was strongest with tree fern seedlings and weakest with mature tree ferns, implying that the palm is preventing the establishment of native tree ferns. This study thus provides strong circumstantial evidence that P. coronata is progressively displacing native tree ferns by preventing seedling establishment and poses a severe threat to Fiji’s native biodiversity and ecological processes. Therefore, urgent management is required to control and prevent the further spread of P. coronata and its negative impacts on native plant biodiversity. Management should involve an initial feasibility study to determine the effectiveness of various management strategies, followed by targeted control and/or eradication campaigns and long-term monitoring. Ultimately, well implemented legislation to prevent the spread and introduction of P. coronata and other ornamental plants will be crucial to protect native biodiversity in Fiji and elsewhere.

scholarly journals Social inequalities in the burden of care: a dyadic analysis in the caregiving partners of persons with a physical disability

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hannah Tough ◽  
◽  
Martin W. G. Brinkhof ◽  
Johannes Siegrist ◽  
Christine Fekete
Keyword(s):  
Caregiver Burden ◽  
Process Model ◽  
Social Inequalities ◽  
Home Ownership ◽  
Financial Strain ◽  
Subjective Burden ◽  
Stress Process Model ◽  
Partner Effect ◽  
Objective Burden ◽  
Subjective Caregiver Burden

Abstract Background Socioeconomic position (SEP) is an important contextual factor in the Stress Process Model of caregiving. However, the basic assumption that low SEP is associated with greater caregiver burden has so far lacked empirical support. The objective of this study was to investigate social inequalities in the caregiver burden among caregiving partners of persons with a physical disability, i.e., spinal cord injury (SCI), applying a dyadic approach. More specifically, we investigated 1) the association of the caregivers’ SEP with caregiver burden (‘actor effect’); 2) the association of the care-receivers’ SEP with caregiver burden (‘partner effect’), and 3) potential mediators of the association between SEP and caregiver burden. Methods Cross-sectional survey data from 118 couples of persons with SCI and their partners living in Switzerland was used. We firstly employed logistic regression to investigate the actor and partner effects of SEP on objective (hours of caregiving) and subjective caregiver burden (Zarit Burden Interview). We additionally used structural equation modelling to explore whether unfulfilled support needs, psychosocial resources and the care-receivers health status mediated the association between SEP and caregiver burden. SEP was operationalized by household income, education, subjective social position, financial strain and home ownership. Results We observed a consistent trend towards higher objective and subjective burden in lower SEP groups. Caregivers with higher subjective social positon and home ownership indicated lower subjective burden, and caregivers with higher education and absence of financial strain reported lower objective burden. Further evidence suggested a partner effect of SEP on caregiver burden, whereby objective caregiver burden was reduced in couples where the care-receiver had a higher educational level. The negative association between SEP and subjective burden was partially mediated by the unfulfilled support needs and deprived psychological resources of the caregiver, and the poor health status of the care-receiver. Similar mediation effects were not supported for objective burden. Conclusions Our study, in the context of SCI, provides support for the contextual role of SEP in the Stress Process Model of caregiving. To reduce subjective caregiver burden, policy programs may target the strengthening of psychosocial resources, or the improvement of access to support services for caregivers with low SEP.

From Necropraxis to Necroresistance: Transgender Experiences in Latin America

2020 ◽  
pp. 088626052098039
Author(s):  
Sheilla L. Rodríguez Madera
Keyword(s):  
Latin America ◽  
Social Interactions ◽  
Management Strategies ◽  
State Policies ◽  
Sociocultural Context ◽  
Multiple Forms ◽  
Trans People ◽  
Small Doses ◽  
Political Economic ◽  
Depth Interviews

Latin America is one of the deadliest regions for trans communities. Scientific research generated in the region has reported that trans people live through a complicated panorama shaped by multiple forms of oppression, extreme violence, and micro-aggressions. Although necropolitics, as a theoretical approach, has been useful to understand how State policies negatively affect trans individuals, it does not fully account for informal dynamics within groups and among individuals that are potentially lethal for this population in Latin America. To account for this gap, the author proposes two novel concepts: necropraxis (a pattern that manifest itself in everyday social interactions, through which gradual small doses of death are delivered to eliminate, symbolically and/or literally, trans people); and necroresistance (the ways in which trans people defy the threats imposed by necropraxis through “ordinary” acts manifested in their everyday life). The main objective of this article is to put forth definitions for these two concepts and identify how they apply in the context of trans communities in three countries of the region: Guatemala, Argentina, and Chile. To achieve the latter, the author relies on her ethnographic work in these contexts. Data were gathered through parcipant observation, in-depth interviews with trans persons ( N = 11) and informal conversations with individuals during the site visits. A deductive qualitative analysis was conducted. Results evidence how the manifestation of necropraxis and necroresistance were highly influenced by the historical, political, economic and sociocultural context of each country. This study provides valuable information to help both policymakers and other stakeholders understand the problem’s magnitude in the region and the ways necropraxis is experienced in everyday relations between trans individuals and others. Similarly, through the understanding of what constitutes necroresistance and its value, the proposed framework could help them outline prevention and management strategies to strengthen trans communities in different countries.

Fathers and Mothers of Patients with Schizophrenia

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Wancata ◽  
M. Freidl ◽  
M. Krautgartner ◽  
F. Friedrich ◽  
T. Matschnig ◽  
...  
Keyword(s):  
Life Events ◽  
Beck Depression Inventory ◽  
Average Duration ◽  
Subjective Burden ◽  
Mothers And Fathers ◽  
Family Counselling ◽  
The Family ◽  
Burn Out ◽  
The Mean ◽  
Objective Burden

Aims:To investigate caregiving and its consequences among fathers and mothers of the same patients suffering from schizophrenia.Methods:101 patients as well as both parents were investigated using the “Carers' Needs Assessment for Schizophrenia”, the “Beck Depression Inventory”, the “Involvement Evaluation Questionnaire” and the “Family Problem Questionnaire”.Results:The mean number of days fathers lived together with the patients was not significant from that of the mothers, but the average duration (hours per week) of contact with the patient was significantly higher for mothers than for fathers. Among 40% of the sample, fathers and mothers spend an equal amount of time caring for the patient. Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed some interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Mothers reported overall higher numbers of problems and needs for intervention than fathers. The overall score of caregivers' involvement did not differ significantly between fathers and mothers. The mothers' objective burden was significantly higher than the fathers' objective burden, but parents did not show differences concerning subjective burden. Using the “Beck Depression Inventory”, mothers were more often depressed than fathers.Conclusions:This study shows that often fathers and mothers spend an equal amount of time caring for the patient. The differences found between mothers and fathers should be considered when planning services for family caregivers.

scholarly journals Burden and Anxiety in Family Caregivers in the Hospital That Debut in Caregiving

2019 ◽  
Vol 16 (20) ◽  
pp. 3977 ◽  
Author(s):  
Margarita Pérez-Cruz ◽  
Laura Parra-Anguita ◽  
Catalina López-Martínez ◽  
Sara Moreno-Cámara ◽  
Rafael del-Pino-Casado
Keyword(s):  
Cognitive Impairment ◽  
Cross Sectional Study ◽  
Care Recipient ◽  
Subjective Burden ◽  
Cross Sectional ◽  
The Hours ◽  
Objective Burden ◽  
The Relationship ◽  
Stay Hospital ◽  
Basic Adls

This cross-sectional study aims to determine the level of subjective burden and anxiety of caregivers of dependent older relatives that start providing care in the hospital and to analyse the relationship between objective burden, subjective burden and anxiety in these caregivers. Seventy-two caregivers of dependent older relatives were recruited in a medium–long stay hospital. Sociodemographic variables, number of basic activities of daily living (ADLs) attended, hours of surveillance, burden, and anxiety were collected from caregivers. A trajectory analysis was used to analyse the relationship between variables. Of the caregivers, 36.1% had subjective burden and 14.9% had anxiety. Subjective burden was positively associated with the number of basic ADLs attended, the hours of surveillance, and the cognitive impairment of the care recipient. Anxiety was also positively associated with subjective burden. Subjective burden mediated the effects of the number of basic ADLs attended, hours of surveillance and the cognitive impairment of the care recipient on anxiety. The levels of subjective burden and anxiety in caregivers debuting in hospital care are elevated, showing the need for these caregivers to be cared for. Subjective burden is a possible risk factor for anxiety, independent of the objective burden; it may buffer the effects of objective burden on anxiety.

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