Relationships Between Care Burden, Resilience, and Depressive Symptoms Among the Main Family Caregivers of Stroke Patients: a Cross-sectional Study

Background Although studies indicate that resilience is related to care burden, and depressive symptoms, the underlying mechanism between those variables remains unknown. Thus, the present study aimed to explore the potential mediating role of resilience between care burden and depressive symptoms. Methods A cross-sectional study was conducted with a convenience sample of 245 main family caregivers of stroke patients recruited from the neurology department of Tertiary A hospital of China. The self-designed demographic characteristics for patients and caregivers、Barthel Daily Living Activities Index (BDLAI)、Zarit Caregiver Burden Interview (ZBI)、Connor-Davidson Resilience Scale (CD-RISC), and Center for Epidemiological Studies Depression Scale (CES-D) were used for investigation. Structural equation modeling (SEM) was conducted to explore the relationships between care burden, resilience, and depressive symptoms among the main family caregivers of stroke patients༎ Results The average scores of care burden, resilience, and depressive symptoms for caregivers were 43.89 ± 13.40, 55.68 ± 11.01, and 22.33 ± 9.85, respectively. Pearson correlation analysis results showed that the care burden was positively related to depressive symptoms (r = 0.578, p < 0.01), resilience was significantly negatively related to both care burden (r = -0.264, p < 0.01) and depressive symptoms (r = -0.697, p < 0.01). Structural equation models (SEM) analysis indicated that resilience partially mediated the relationship between care burden and depressive symptoms with the mediation effect ratio of 23.8%. Conclusions Our study signifies that resilience plays a mediating role between care burden and depressive symptoms among the main family caregivers of stroke patients. This finding shows us that resilience can be a critical source to alleviate depressive symptoms.

Orbánistan and the Anti-gender Rhetoric in Hungary

This chapter introduces Hungary’s anti-liberal political rule and its gender regime. It traces policy changes in Hungary since 2010, discusses the legacies of the state socialist gender regimes and the formation of a new, anti-liberal one. I introduce the term “carefare” and discuss how the concept of “gender” has been deployed by Hungarian politicians to legitimate an increase in women’s unpaid care burden and their lack of attention to gender inequality in the labor market. I end the chapter with a description of my research methods and provide an outline for the rest of the book.

Predictors of Sleep Among Spousal Care Dyads Living With Chronic Conditions

Sleep health relates closely to physical health and well-being among older adults with chronic health conditions. However, little is known about the dyadic sleep patterns of these individuals and their spousal caregivers. Secondary analyses of the 2015 National Health and Aging Trends Study and National Study of Caregiving (N= 62 care dyads, mean age 78.59 years for care recipients and 75.77 years for caregivers) were completed to examine the sleep patterns, and related factors, of spousal dyads at both the individual and dyadic levels. Sleep measures included frequency in trouble falling back asleep and insomnia symptoms. Predictors included demographics, depressive symptoms, and positive affect for dyads and contextual factors such as dementia caregiving, care burden and support, neighborhood cohesion, and relationship quality. Multilevel dyadic and actor-partner interdependence models were used to complete analyses. Though intraclass correlation was poor (dementia care dyads ICC=0.123, non-dementia care dyads ICC=0.043), persons with dementia/spousal caregiver dyads (n=102) had more similar sleep and insomnia patterns than dyads with other chronic conditions. Poor sleep among dyads was correlated with higher care burden (β = -0.31, p &lt;.0001), however, better relationship quality marginally enhanced the association (β = -0.23, p = .08). Individual depressive symptoms negatively affected dyadic sleep patterns. However, positive affect only had an actor effect and was related to better individual sleep. Other contextual factors did not affect sleep patterns. These findings suggest the importance of both caregiver and care recipient characteristics on sleep at dyadic levels, particularly those with dementia.

Incidence and mortality of necrotizing fasciitis in The Netherlands: the impact of group A Streptococcus

Background Little is known about the exact incidence of necrotizing soft tissue infections. The few incidences reported in international literature are not directly relatable to the Netherlands, or other European countries, due to geographic heterogeneity in causative micro-organisms involved. This resulted in the aim of this study to map the incidence, mortality rate and hospital course of necrotizing fasciitis infections in the Netherlands to gain insight in the incidence of necrotizing fasciitis in the Netherlands and the associated mortality and health care burden. Methods This nationwide retrospective database study used three distinct data sources to map the incidence of necrotizing fasciitis in the Netherlands between 2014 and 2019, being data from the Dutch Hospital Data (DHD) foundation, data from Osiris-AIZ, which is a database of notifiable diseases managed by regional Public Health Services (GGD) and the National Institute for Public Health and the Environment (RIVM), and previously published studies on necrotizing fasciitis conducted in the Netherlands. Results The incidence of necrotizing fasciitis in the Netherlands is estimated to be approximately 1.1 to 1.4 cases per 100,000 person years, which corresponds to 193–238 patients per year. Of all necrotizing fasciitis infections, 34 to 42% are caused by the group A Streptococcus. Annually, 56 patients die as a result of a necrotizing fasciitis infection (mortality of 23–29%) and 26 patients undergo an amputation for source control (11–14%). Patients stay a mean of 6 to 7 days at the intensive care unit and have a mean hospital length of stay of 24 to 30 days. Conclusion The combination of nationwide databases provides reliable insight in the epidemiology of low-incidence and heterogenic diseases. In the Netherlands, necrotizing fasciitis is a rare disease with group A Streptococcus being the most common causative micro-organism of necrotizing fasciitis. The prior Dutch cohort studies on necrotizing fasciitis report slightly higher sample mortality rates, compared to the population mortality. However, necrotizing fasciitis remain associated with substantial morbidity and mortality, risk at amputation and health care burden characterized by prolonged ICU and hospital stay.

Factors Influencing the Quality of Life among Family Caregivers of the Elderly with Dementia

Purpose: The purpose of this study was to identify quality of life of family caregivers and to investigate factors positively and negatively affecting family caregivers’ quality of life.Methods: Participants were 153 family caregivers taking care of dementia elderly. Collected data were general characteristics, quality of life, care burden, depression, social support, family relationship, and problematic behaviors. Data were analyzed using descriptive statistics, independent t-tests, Pearson correlation coefficient, and multiple regression.Results: Mean age of participants was 58.70±13.88. The average scores of main variables for family relationship, social support, quality of life, care burden, problematic behaviors and depression were 3.99±1.08, 3.34±0.84, 3.00±0.63, 1.96±0.51, 1.48±1.06, 1.17±0.71 and 1.13±0.61, respectively. In regression analysis, depression (β=-.20), subjective health (β=.26), social support (β=.23), education level (β=-.20), and care burden (β=-.22) accounted for 59.1% of the variance in quality of life.Conclusion: To increase quality of life for family caregivers, interventions should be focused on reducing depression and care burden, enhancing caregiver’s health and social support. especially for family caregivers who received lower education.

A new perspective on women’s care burden and employment in Turkey

Women’s intra-household care burden is one of the main reasons behind women’s low employment rates in Turkey. Many empirical studies have tested this relationship by focusing on the existence of dependent household members, if any. They have largely overlooked the use of care services and the time spent on caring for dependent household members to evaluate women’s care burden. The purpose of this study is to examine the relationship between women’s care burden and employment prospects and status in Turkey from the perspective of access to care services and the time dimension of the care burden. This relationship is analyzed through the logit model by using latest available data from the 2014–2015 Time Use Survey. The article shows that the time spent by women caring for dependent household members, and access to care services, are the most important factors influencing women’s employment probability in Turkey. Benefiting from informal childcare services increases the employment probability of women approximately twenty-seven times, while benefiting from formal childcare services increases two times and informal adult-care services 2.6 times. Ensuring the accessibility of institutional care services improves women’s employment status by enabling women’s transition from part-time to full-time jobs, and from unskilled to professional jobs.