Factors associated with the self-reported health status of female caregivers of AIDS patients

A cross-sectional study was conducted on women who were family caregivers of spouses with AIDS, living in the Bumbu Zone, Kinshasa, Democratic Republic of Congo. Eighty caregivers were randomly selected from a client visitation list of the home-based care program for AIDS patients. A semistructured questionnaire was used in face-to-face interviews. A self-reported health status score was calculated using five items from the questionnaire. The self-reported health of female caregivers indicates poor health. Lower caregiver health is associated with lower income, rented accommodation, little support, and stigmatization of the caregiver by relatives.     

Factors associated with burden in primary caregivers of mentally ill patients.

The objectives of this study are to describe caregivers' subjective burden and to identify the predictors of burden in primary caregivers of mentally ill outpatients recruited from eight hospitals in Montreal, Quebec, Canada. Patient and primary caregiver variables, were regressed on perceived burden using hierarchical regression analysis. The variables describing the patient's current state contributed the most to explaining variance in subjective burden. The variables related to psychiatric history and to outpatient treatment also explained a significant proportion of the variance in the burden scores. Better understanding of the factors associated with subjective burden will enable researchers and practitioners to identify those caregivers that are at greater risk for higher levels of burden, and to develop more focused and appropriate interventions.     

护理干预对艾滋病患者亲属照顾者不良心理行为表现的影响

目的 探讨护理干预对艾滋病患者亲属照顾者不良心理反应及行为表现的影响.方法 选择经评估具有不良心理反应及行为表现的住院艾滋病患者的亲属照顾者65例,随机分为对照组30例,观察组35例,对照组患者亲属照顾者给予一般常规护理,观察组在常规护理基础上进行护理干预,观察两组患者亲属照顾者不良心理反应及行为表现情况.结果 观察组患者亲属照顾者经护理干预后其不良心理反应及行为表现较对照组明显减轻,差异有统计学意义(P＜0.01).结论 护理干预可减轻艾滋病患者亲属照顾者不良心理反应及行为表现,对患者及其亲属照顾者起到积极作用.

Abstract：

Objective To investigate mining intervention's influence on relative caregivers of AIDS patients with adverse psychological reactions and behavior. Methods Sixty five cases with advene psychological reactions and behavior of the relative caregivers of AIDS patients in hospital were selected and randomly divided into control group 30 cases and observation group 35 cases. Relative caregivers of patients in control group were given routine nursing care, while nursing interventions were added in observation group, the two groups of caregivera' adverse psychological reactions and behavior were observed. Results The patients relative caregiven in observation group with advene psychological reactions and behavior were significantly reduced compared with the control group. The difference was statistically significant (P＜0.01) . Conclusions Nursing intervention can reduce advene psychological reactions and behavior of relative caregivers of AIDS patients, and play a active role to them.     

护理干预对艾滋病患者亲属照顾者不良心理行为表现的影响

Objective To investigate mining intervention's influence on relative caregivers of AIDS patients with adverse psychological reactions and behavior. Methods Sixty five cases with advene psychological reactions and behavior of the relative caregivers of AIDS patients in hospital were selected and randomly divided into control group 30 cases and observation group 35 cases. Relative caregivers of patients in control group were given routine nursing care, while nursing interventions were added in observation group, the two groups of caregivera' adverse psychological reactions and behavior were observed. Results The patients relative caregiven in observation group with advene psychological reactions and behavior were significantly reduced compared with the control group. The difference was statistically significant (P＜0.01) . Conclusions Nursing intervention can reduce advene psychological reactions and behavior of relative caregivers of AIDS patients, and play a active role to them.     

护理干预对艾滋病患者亲属照顾者不良心理行为表现的影响

Objective To investigate mining intervention's influence on relative caregivers of AIDS patients with adverse psychological reactions and behavior. Methods Sixty five cases with advene psychological reactions and behavior of the relative caregivers of AIDS patients in hospital were selected and randomly divided into control group 30 cases and observation group 35 cases. Relative caregivers of patients in control group were given routine nursing care, while nursing interventions were added in observation group, the two groups of caregivera' adverse psychological reactions and behavior were observed. Results The patients relative caregiven in observation group with advene psychological reactions and behavior were significantly reduced compared with the control group. The difference was statistically significant (P＜0.01) . Conclusions Nursing intervention can reduce advene psychological reactions and behavior of relative caregivers of AIDS patients, and play a active role to them.     

Losses associated with AIDS

Acquired immunodeficiency syndrome has a considerable effect in many areas: individual, social, economic, demographic and cultural. Its emotional impact alone is pervasive and characterized by catastrophic losses of health, employment, independence and friends or loved ones. This study describes these losses.     

Stress associated with tasks for family caregivers of patients with cancer in Hong Kong.

Family caregivers share the strain of cancer and are at risk of physical and psychological symptoms in relation to caregiver stress. This study investigated the relationships between perceived difficulty in managing caregiver tasks and the experience of stress symptoms among 26 family caregivers of terminally ill patients with cancer in Hong Kong. The findings revealed that more stress symptoms were experienced by caregivers who had reported increased difficulty in managing caregiver tasks (rs = 0.64; p < 0.001). Wilcoxon signed-ranks test indicated that psychological stress symptoms, rather than physical symptoms, overwhelmed most of the caregivers (z = -2.15; p < 0.05). There were significantly more negative responses to stress by caregivers who had a shorter duration of experience in providing care. In addition, caregivers who had less education were at higher risk of developing stress (p < 0.01). These findings indicate the need for the provision of support to facilitate the emotional and physical adaptation of caregivers at risk for health problems.     

Stigma: a health barrier for women with HIV/AIDS.

The stigma experienced by women with HIV/AIDS is much like that of Hester Prynne in The Scarlet Letter. At the time of diagnosis with HIV/AIDS, women already are aware of the stigma associated with the disease. They immediately see themselves differently and believe others do also. The purpose of this article is to explore the multidimensional effect of stigma on women's efforts to promote, maintain, and enhance their health. The experiences of the women in this study tell of rejection by family members, friends, health care providers, employers, and church members. This rejection caused by stigma affects access to health care, medication adherence, social interaction, and social support. Interventions are needed to decrease the impact of stigma on women with HIV/AIDS so they can achieve a higher level of wellness, increase their life span, continue in the workforce, and improve their quality of life.     

Modifiable factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients

Purpose

Higher caregiver burden is associated with poor quality of life among family caregivers. However, in Korea, very few studies have examined factors associated with caregiver burden. The present study investigated factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients, particularly modifiable factors as a potential target of intervention strategies.

Methods

A cross-sectional study using self-administered questionnaires was performed. Sixty-four family caregivers of terminally ill cancer patients who were admitted to the hospice-palliative care unit of a university hospital in South Korea were included. To identify caregiver burden, the Caregiver Reaction Assessment scale (CRA) was used in this study. Time spent in providing care per day, number of visits per week from other family members, family functioning, and a positive subscale, self-esteem, of the CRA were deemed as modifiable factors. Other sociodemographic, caregiving characteristics of the subjects were non-modifiable factors.

Results

Longer time spent providing care per day, fewer weekly visits from other family members, poor family functioning, and low self-esteem were considered as modifiable factors associated with caregiver burden. Low monthly income and the spouse being the family caregiver were non-modifiable factors.

Conclusions

Our study has practical significance in that it identifies modifiable factors that can be used to devise intervention strategies. Developing and applying such intervention strategies for alleviating the factors associated with high caregiver burden could be important for improving the quality of life of both patients and their families.     

Relationships of cognitions associated with coping reactions to depression in spousal caregivers of Alzheimer's disease patients

Attributions (globality and stability) related to the reformulated learned helplessness (RLH) model of depression, and attributes, self-evaluations, and expectancies concerning coping reactions (degree of upset, success, satisfaction, control in future, future coping success) postulated by Wortman and Dintzer (1978) were examined for their respective relations to severity and prevalence of diagnosable depression in a highly stressed sample (N =68) of spouse caregivers of Alzheimer's disease patients. Subjects' attribution-related cognitions concerning two situational contexts were obtained: (1) an unpredictable upsetting behavior by the Alzheimer patient, and (2) significant life change experienced by the caregiver as a result of his/her spouse's Alzheimer's disease. The results indicated that only globality was related to depression for the Alzheimer patient's unpredictable behavior; however, both globality and stability were related to depression for the subject's life change situation. The pattern of the other depressogenic coping cognitions was also different for the two contexts: While ratings of upset and lack of current and future control were related to depression for the Alzheimer patient's behavior, ratings of poor current and future coping, lack of coping success, and coping dissatisfaction were related to depression for the subject's life change context. The discussion of the contextual specificity of coping cognitive patterns focused on the possible significance of the intrapersonal versus the interpersonal nature of the situational context. This study was funded by National Institute of Mental Health Grant MH33779 to the third author.     

Development of an Instrument to Measure Internalized Stigma in Those with HIV/AIDS

Stigma has grave consequences for persons living with HIV/AIDS. Stigma hampers prevention of HIV transmission to sexual partners and to unborn babies, diagnosis, and early treatment, and negatively affects mental and physical health, quality of life, and life satisfaction. Internalized stigma of HIV/AIDS may have even more severe consequences than perceived or enacted stigma. The purpose of this study was to develop an instrument to measure internalized stigma in those with HIV/AIDS.

Data were drawn from the Rural Women's Health Project. Research assistants administered structured interviews at baseline, 3 months, and 6 months. Instruments used in these analyses included a demographic data form, the Centers for Epidemiological Studies Depression Scale (CES-D), the Perceived Stigma Scale (PSS), and the Internalized Stigma of AIDS Tool (ISAT). Exploratory factor analysis confirmed that the ten items of the ISAT measure a single factor that explains 88% of the variance in the construct. Internal consistency was demonstrated by a Cronbach's alpha of .91 (Time 1), .92 (Time 2), and .92 (Time 3). Convergent validity was supported with significant positive correlations with the CES-D (rho = 0.33, p < 0.0001) and the PSS (rho = 0.56, < 0.0001). The Internalized Stigma of AIDS Tool appears to be a reliable and valid instrument to measure internalization of the stigma of HIV/AIDS. It may be of value in research and clinical assessment.     

Cytokine gene variation is associated with depressive symptom trajectories in oncology patients and family caregivers

PurposeDepressive symptoms are common in cancer patients and their family caregivers (FCs). While these symptoms are characterized by substantial interindividual variability, the factors that predict this variability remain largely unknown. This study sought to confirm latent classes of oncology patients and FCs with distinct depressive symptom trajectories and to examine differences in phenotypic and genotypic characteristics among these classes.MethodAmong 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on Center for Epidemiological Studies-Depression (CES-D) scores obtained prior to, during, and for four months following completion of radiation therapy. One hundred four single nucleotide polymorphisms (SNPs) and haplotypes in 15 candidate cytokine genes were interrogated for differences between the two largest latent classes. Multivariate logistic regression analyses assessed effects of phenotypic and genotypic characteristics on class membership.ResultsFour latent classes were confirmed: Resilient (56.3%), Subsyndromal (32.5%), Delayed (5.2%), and Peak (6.0%). Participants who were younger, female, non-white, and who reported higher baseline trait and state anxiety were more likely to be in the Subsyndromal, Delayed, or Peak groups. Variation in three cytokine genes (i.e., interleukin 1 receptor 2 [IL1R2], IL10, tumor necrosis factor alpha [TNFA]), age, and performance status predicted membership in the Resilient versus Subsyndromal classes.ConclusionsFindings confirm the four latent classes of depressive symptom trajectories previously identified in a sample of breast cancer patients. Variations in cytokine genes may influence variability in depressive symptom trajectories.     

艾滋病合并马尔尼菲青霉病家庭照顾者内心体验的质性研究

[目的]了解艾滋病合并马尔尼菲青霉病病人的家庭照顾者入院时的内心体验。[方法]对31名艾滋病合并马尔尼菲青霉病病人的家庭照顾者进行深度半结构式访谈,采用Colaizzi现象学研究方法进行资料分析。[结果]提炼出4个主题:应激反应强烈;信息与支持系统缺乏;经济负担加重;对未来的不确定与担忧。[结论]家庭照顾者陪同入院时存在多种负面心理,应及时给予疾病相关指导及心理疏导,满足其心理诉求,缓解压力和恐惧,使他们更好地帮助病人配合治疗与护理,促进康复。