The Coping with Caregiving Group Program for Chinese caregivers of patients with Alzheimer's disease in Hong Kong

Objective

This pilot study evaluated the effectiveness of Coping with Caregiving (CWC) psychoeducational program for Chinese family caregivers of patients with Alzheimer's disease in Hong Kong.

Method

Twenty-seven female primary caregivers were randomized to join the treatment group or wait-list control group. The caregivers in the treatment group participated in 13 weekly training sessions which taught specific cognitive–behavioral strategies to handle caregiving stress.

Results

As compared to the wait-list control group, caregivers completing the CWC program demonstrated a significant increase in their self-efficacy for controlling their upsetting thoughts and handling disruptive behaviors of the care recipients. They also reported a significant increase in the use of both problem-focused and emotion-focused coping strategies.

Conclusion

These findings suggested that cognitive–behavioral programs can be effective in improving the resourcefulness of Chinese caregivers of persons with dementia in Hong Kong.

Practice implications

Future CWC programs will have to enhance participants’ ability to differentiate among various coping skills and to use situation-appropriate strategies.     

癫痫患者家属的心理状况调查分析

目的调查癫痫患者家属的心理状况。方法使用焦虑自评量表（SAS）对60例确诊为癫痫患者的家属进行调查,并与中国成人常模对照,分析其结果。结果60倒癫痫患者家属中有42例（70％）存有轻至中度抑郁情绪,36例（60％）存有肯定的焦虑。结论癫癫患者家属因患者的一系列心理变化,从而产生出现紧张、恐惧,焦虑,悲观等心理变化,同时这种紧张焦虑的心理状态还与药物副作用,疗效,癫痫发作类型等等有密切关系。     

Educational support group in changing caregivers’ psychological elder abuse behavior toward caring for institutionalized elders

Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver’s psychological abusive behavior, reducing work stress and promoting knowledge of geriatric care-giving among a group of caregivers. A quasi-experimental design using a case control pre–post test approach was conducted. A total of 100 participants completed the study with 50 caregivers in each group. The research instruments included the Caregiver Psychological Elder Abuse Behavior Scale (CPEAB), the Work Stressors Inventory (WSI), and the Knowledge of Gerontology Nursing Scale (KGNS). The results showed that the intervention had significant effects in alleviating caregiver psychological abuse behavior and increasing care-giving knowledge in the experimental group (p = .048; .018). However, the intervention had no measurable effect on work stress (p = .66). Findings have important implications for education and programming for facility administers and long-term care policy makers when planning quality improvement for elderly care.     

With a little help from my friends: psychological, endocrine and health corollaries of social support in parental caregivers of children with autism or ADHD

Elevated psychological distress and concomitant dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated as one pathway that links the stress of caregiving with adverse health outcomes. This study assessed whether perceived social support might mitigate the psychological, endocrine and health consequences of caregiver stress in parents of children with autism and attention deficit hyperactivity disorder (ADHD). Parental caregivers completed measures of psychological distress, perceived availability of social support and physical health complaints. To capture important parameters of the basal diurnal cortisol pattern, caregivers collected salivary cortisol at waking, 30 min post waking, 1200 h and 2200 h on two consecutive weekdays. Psychological distress and self reported physical health complaints were inversely related to scores on all support subscales: tangible, belonging, self esteem and appraisal. Results further revealed a significant, positive association between magnitude of the cortisol awakening response (CAR) and caregivers’ self esteem. As a buffer between the stress of caregiving and adverse physical health outcomes, social support acts to reduce stress appraisals and mitigate disturbances of the HPA axis. Moving forward, intervention programmes might seek to increase caregivers’ perceived availability of social resources.     

Quality of life and its associated factors among patients with two common types of chronic mental illness living in Kaohsiung City

Aim: This study explored the associations of personal, disease, family, and social factors with quality of life (QoL) in patients with two common types of chronic mental illness (CMI) living in Kaohsiung City, Taiwan. Methods: Using a convenience sample and a cross‐sectional design, 714 patients (50.1% male, 49.9% female) with CMI (72.1% schizophrenia and 27.9% affective disorder) and their caregivers were recruited. Demographic information was collected via the following questionnaires: 12‐Item Short‐Form Health Survey (SF‐12), five‐item Brief Symptom Rating Scale (BSRS‐5), Caregiver Burden Scale, and Clinical Global Impressions (CGI‐S) Scale. Pearson correlations and hierarchical regression analyses were used to predict QoL. Results: Disease factors accounted for 17–50% of the change in variance. Predictors of low mental subscale scores included the following: high psychological distress and high family burden as well as a history of suicide attempts, negative caregiver attitudes, and living away from home. Disease factors also explained the greatest variance in the physical subscales. Predictors of low physical subscale scores included the following: high psychological distress, age, unemployment, a history of suicide attempts, high family burden, and living alone. Conclusions: Disease factors were the most important predictors of QoL in patients with CMI. Family factors were more important than social factors on the mental subscales. Differential relationships were also found for the other two dimensions. Together, these results indicate that a wide range of factors improve the QoL in patients with CMI.     

Course of social support and relationships between social support and life satisfaction in spouses of patients with stroke in the chronic phase

Objective

To describe the course of social support in spouses of patients with stroke, and to examine direct and indirect relationships between social support and life satisfaction over time.

Methods

Prospective cohort study (N = 180) with measurements at 2 months after discharge from inpatient rehabilitation, 1 year, and 3 years after stroke. Social support was assessed using the Social Support List-12, Life satisfaction with the Life Satisfaction Questionnaire (LiSat-9) and Caregiver strain with the Caregiver Strain Index. Random coefficient analyses was used.

Results

Total social support and the 3 subtypes of social support decreased significantly over time. In all models, caregiver strain was associated with lower life satisfaction and social support was associated with higher life satisfaction, but there were no interaction effects between caregiver strain and social support on life satisfaction.

Conclusion

Spouses of patients with stroke experienced a decline of social support over time. Social support was positively associated with life satisfaction, regardless of the amount of caregiver strain experienced by the spouses.

Practice implications

It is important to discuss with caregivers of stroke patients the importance of maintaining their own social contacts and to facilitate this by arranging support if appropriate.     

癌症患儿化疗期照顾者焦虑现状及影响因素分析

目的:调查癌症患儿化疗期照顾者的焦虑现状及影响因素,旨在为临床干预提供依据。方法:本研究为横断面调查研究,采用便利抽样法,选取2020年5—8月郑州大学第一附属医院小儿肿瘤内科收治的133名化疗期癌症患儿的照顾者为研究对象,采用一般资料问卷、广泛性焦虑量表（GAD-7）和中文版认知融合问卷（CFQ）进行调查。本研究共发...     

Les enjeux de la transition dans l’anorexie mentale vus par les professionnels : une étude qualitative

IntroductionAnorexia nervosa (AN) is an eating disorder (ED) that emerges during adolescence and may be lasting several years, or even becoming chronic. For these patients, the transition to adult care is a period of high risk of instability, relapse, symptomatic re-aggravation and increased development of co-morbidities or eventually leading to care drop-out or medical nomadism. Professionals involved in the transition process with AN patients are often challenged with various difficulties, and confronted with the need to plan this care stage. This study sought to understand the pediatricians and (child) psychiatrists experience of this transition step and to identify national practices around the transition process for adolescents and young adults with anorexia nervosa.MethodA qualitative study was carried out on the basis of thirteen recorded individual interviews with physicians specialised in eating disorders working in hospital adolescent medicine units or in adult medicine units. The methodology used was IPA (Interpretative Phenomenological Analysis).ResultsVarious difficulties and obstacles to a successful transition emerged as well as perspectives to improve the transition to adulthood care: early identification of the target population, choice of the most adapted unit to the severity level of the disease, family support during the transition, identification of a coordinating physician and enhanced networking support. The opportunity of a transition program is discussed among physicians, who are consistent on the need for guidelines.ConclusionThis qualitative study allowed us to highlight the difficulties of specialized professionals faced to the transition period with AM patients but also to consider the need for specific tools and guidelines to promote continuity to adulthood care.