Coping and Caregiver Burden and Depression Among Chinese Caregivers of Older Adults With Cognitive Impairment

Coping strategies are important factors that influence caregivers’ mental health outcomes. The purpose of this study is to examine the association between coping strategies and caregiver burden and depression among Chinese caregivers of older adults with cognitive impairment. Data came from structured interviews with 300 primary family caregiver-care recipient dyads in Wuhan, China. We used OLS to examine the association between coping strategies and caregiver burden and depression. More positive reframing and acceptance were associated with lower caregiver burden, whereas more self-distraction was associated with higher caregiver burden. More positive reframing was associated with lower caregiver depression, whereas higher self-distraction and religion were associated with higher caregiver depression. Findings of this study suggest that a psychosocial intervention package that emphasizes on enhancing positive reframing skills and affirming acceptance may be effective in reducing caregiver burden and depression among Chinese caregivers of older adults with cognitive impairment.

Social Support and Loneliness Among Chinese Caregivers of Children With Chronic Kidney Disease During the COVID-19 Pandemic: A Propensity Score Matching Analysis

To evaluate social support and loneliness as well as their association among caregivers of children with chronic kidney disease (CKD) from China during the coronavirus disease 2019 (COVID-19) pandemic. We collected data for caregivers of children with CKD and caregivers of healthy children and matched the two groups using propensity score matching (PSM). We compared the differences in social support and loneliness between the two groups after matching and analyzed the relationship between social support and loneliness in the observation group. Before PSM, we analyzed the data for 247 caregivers of children with CKD and 315 caregivers of healthy children from 13 provinces. After PSM, the two groups each included 202 caregivers. The social support score of caregivers of children with CKD was lower than that of caregivers of healthy children (P < 0.002), while the loneliness score was higher for caregivers of children with CKD than for caregivers of healthy children (P < 0.008). The social support score was negatively correlated with the loneliness score (r = −0.598, P < 0.001). Caregivers of children with CKD experienced less social support and greater loneliness than caregivers of healthy children during the COVID-19 pandemic. Therefore, greater attention should be paid to providing social support for caregivers of CKD children and to improving the ability of these caregivers to cope with loneliness.

Care Me Too, a Mobile App for Engaging Chinese Immigrant Caregivers in Self-Care: Qualitative Usability Study

Background Caregiving and self-care are challenging for Chinese immigrants in the United States due to limited accessible support and resources. Few interventions exist to assist Chinese immigrant caregivers in better performing self-care. To address this gap in the literature, our team developed the Care Me Too app to engage Chinese immigrant caregivers in self-care and conducted a user experience test to assess its usability and acceptability. Objective This paper aims to report the results of the app’s usability and acceptability testing with Chinese immigrant caregivers and to solicit participants’ feedback of the app design and functions. Methods A total of 22 Mandarin-speaking Chinese caregivers participated in the study, which consisted of 2 parts: the in-lab testing and the 1-week at-home testing. In-depth face-to-face interviews and follow-up phone interviews were used to assess user experience of the app’s usability and acceptability and to solicit feedback for app design and functions. Directed content analysis was used to analyze the qualitative data. Results Among the 22 participants, the average age was 60.5 (SD 8.1) years, ranging from 46 to 80 years; 17 (77%) participants were women and 14 (64%) had an associate degree or higher. Participants reported uniformly positive ratings of the usability and acceptability of the app and provided detailed suggestions for app improvement. We generated guidelines for mobile health (mHealth) app designs targeting immigrant caregivers, including weighing flexibility versus majority preferences, increasing text sizes, using colors effectively, providing engaging and playful visual designs and functions, simplifying navigation, simplifying the log-in process, improving access to and the content on the help document, designing functions to cater to the population’s context, and ensuring offline access. Conclusions The main contribution of this study is the improved understanding of Chinese caregivers’ user experiences with a language-appropriate mHealth app for a population that lacks accessible caregiving and self-care resources and support. It is recommended that future researchers and app designers consider the proposed guidelines when developing mHealth apps for their population to enhance user experience and harness mHealth’s value.

Care Me Too: A Mobile App for Engaging Chinese Immigrant Caregivers in Self-Care and Its User-Experience Testing

Caregiving and self-care are challenging for Chinese immigrants in the U.S. due to limited accessible support and resources. The team developed a Care Me Too app for engaging Chinese immigrant caregivers in self-care and conducted a user-experience test to assess its usability and acceptability. The aims of this paper are to report the testing results and develop guidelines to support mHealth app design for immigrant caregiver populations. Twenty-two Chinese caregivers participated in the test, which consisted of two parts: in-lab testing and one-week at-home testing. In-depth face-to-face interviews and follow-up phone interviews were used to test the app’s usability and acceptability and solicit participants’ feedback for app design and functions. Directed content analysis was used to analyze testing transcripts. Participants reported uniformly positive ratings of usability and acceptability of the app and provided detailed suggestions for app improvement. We generated some mHealth app design guidelines, including weighing flexibility vs. targeting majority preferences, increasing text sizes, using colors effectively, providing engaging and playful visual designs and functions, simplifying navigation, simplifying login process, design functions to cater to the population’s context, etc. We concluded that culturally and linguistically appropriate mHealth apps are appealing to immigrant caregivers for health promotion.

Developing and Refining an End-of-Life Care Manual for Chinese Immigrant Caregivers

Planning for end-of-life (EOL) care in advance can enhance one’s quality of life at EOL and decrease caregiver stress and anxiety. Culturally sensitive educational programs are needed to educate the public and encourage advance planning. This paper describes the team’s efforts to develop and evaluate an EOL manual designed for Chinese immigrant caregivers. In 2019, one-on-one interviews were conducted with six Chinese caregivers and five Chinese geriatric social workers in Los Angeles County to obtain their feedback on manual improvement. Detailed suggestions included adding more content in the introduction to decrease fear for discussing death-related topics, such as using the concept of “life in four seasons”; having more case examples as how to initiate advance planning conversation with the older adult under different circumstances; adding content on how advance care planning and its documentation is legally protected, etc. Culturally sensitive advance planning community education is feasible among immigrant populations.

eHealth Literacy and Caregiver Burden Among Chinese Caregivers of Older Adults With Cognitive Impairment: Does Education Matter?

eHealth literacy is a critical factor that influences caregivers’ well-being. The purpose of this study is to examine the association between eHealth literacy, education, and caregiver burden among Chinese caregivers of older adults with cognitive impairment. Data came from structured interviews with 300 primary family caregiver–care recipient dyads in Wuhan, China. We used logistic regression to examine the association between eHealth literacy, education, and caregiver burden. An interaction effect between eHealth literacy and education on caregiver burden was identified. eHealth literacy was positively associated with caregiver burden among caregivers with less than a high school education, but not among those with a high school education or above. eHealth literacy is salient in the burden experienced by caregivers with low education. eHealth literacy needs to be enhanced with health information verification from health professionals and programs to support caregiving efficacy to realize its positive impact on caregivers’ mental health.