Resourcefulness Training for Grandmothers: Feasibility and Acceptability of Two Methods

Grandmothers raising grandchildren may benefit from interventions to minimize stress and promote mental health. This pilot intervention trial with 40 grandmothers examined the acceptability and feasibility of resourcefulness training (RT) using expressive writing (EW) or verbal disclosure (VD). Grandmothers in RT-EW reported challenges with the daily journaling, facing reality, and not using names; those in RT-VD listed daily recording, sharing feelings, and device failures as challenges. Word counts were greater with VD than EW, but EW was used more frequently than VD. However, both EW and VD were found acceptable and feasible for practicing RT skills in grandmothers raising grandchildren and warrant further evaluation.     

Need for Resourcefulness Training for Women Caregivers of Elders with Dementia

Nearly ten million American women are caregivers of elders with dementia and may experience overwhelming stress that adversely affects their mental health. Interventions to teach them resourcefulness skills for managing stress can promote optimal mental health and facilitate continued caregiving. However, effectiveness of resourcefulness training (RT) cannot be examined until its need is established. This pilot trial with 138 women caregivers of someone with dementia examined the need for RT using subjective and objective data. Data were collected before and after RT. Data analysis focused on baseline resourcefulness scores (higher scores = lower need); scores in relation to attrition; correlations among resourcefulness, stress, and depressive symptoms; and post-RT evaluation of the need for RT. Baseline resourcefulness scores were normally distributed and showed that 74% of the caregivers had a moderate to high need for RT. Reasons for attrition were unrelated to the need for RT; however, caregivers who dropped out had resourcefulness scores that averaged two points higher than those who remained in the study. Lower resourcefulness was associated greater stress (r = –.37, p < .001) and depressive symptoms (r = –.52, p < .001). Of the 63 caregivers who received RT, 82% (n = 52) reported a felt need for RT and 94% (n = 59) believed that other caregivers need RT. The results suggest a substantial need for resourcefulness training in women dementia caregivers and support moving forward to test RT's effectiveness for reducing caregiver stress and depressive symptoms.     

Online Positive Thinking Training Intervention for Caregivers of Individuals with ASD: Necessity,Acceptability and Feasibility

Background: More than 3.5 million people in the United States are diagnosed with autism spectrum disorder (ASD). Caring for children with ASD can be stressful and can be detrimental to the well-being of the caregivers (CGs). However, the adverse effects of caregiving on the well-being of CGs may be avoided with appropriate interventions. CGs of persons with ASD might benefit from a positive thinking training (PTT) intervention to help them cope with the stress of caregiving. However, the necessity, acceptability and feasibility for PTT in ASD CGs have not been studied.

Objective: To examine the necessity, acceptability and feasibility of a six-week online PTT intervention designed to improve the well-being of the CGs.

Design: Random assignment of ASD CGs to one of two conditions: (1) PTT online intervention or (2) Control group.

Results: The mean score on the depressive cognition scale (DCS) was 20, indicating a high need of PTT to all enrolled CGs. High depressive cognitions in ASD CGs were associated with lower positive thinking (r = ?.39; p <.001). Regarding acceptability, CGs indicated that the different strategies and references to real life were the most interesting parts of the intervention. Regarding feasibility, CGs mentioned that listening to the voice-over PowerPoint and visualization was the easiest part of the PTT.

Conclusions: Examination of the fidelity and effectiveness of the PTT are the next steps in the refinement of this intervention.     

社区失智老人居家照顾者照护技能培训效果研究

目的 探讨对社区失智老人居家照顾者实施照护技能培训的效果.方法 通过调查上海市某社区失智老人居家照顾者照护技能现状及需求,并基于循证医学与专家论证,制定"失智老人居家照顾者照护技能培训方案".选取失智老人居家照顾者39名,按照"失智老人居家照顾者照护技能培训方案"实施为期3个月的培训.采用自行设计的失智老人居家照顾者照护技能调查问卷、世界卫生组织生活质量简表进行干预前后评估.结果 干预后居家照顾者照护技能得分、生活质量得分均明显高于干预前((t=10.710,t=7.778),差异均具有统计学意义(P<0.01).结论 规范化的照护技能培训,可以有效提高社区失智老人居家照顾者照护技能,提升照顾者的生活质量.     

Realist Review: Understanding Effectiveness of Intervention Programs for Dementia Caregivers

Purpose

Caring for patients with dementia is a challenging issue entailing heavy responsibility. Many interventions for caregivers have been developed, but their effectiveness is not clear. This study aimed to examine how, why, and under what circumstances interventions for dementia caregivers affected their burden of caring.

上海老年期痴呆照护者身心状况分析

目的评估上海老年期痴呆照护者负担及容忍度。方法在前期老年期痴呆现况调查的基础上,对1271例患者的照护者进行问卷调查,内容涉及照护者的人口学特征、照顾老人对照护者身体、心理、生活的影响以及对各种非适应性行为的容忍度。结果近60%的照护者感到有精神压力,近40%的照护者认为精神压力对自身健康造成了不良影响;照护者对患者的各种非适应性行为能报以容忍态度。结论照护者身心状况不佳,有必要尽快探索建立老年期痴呆患者的社会支持体系。     

Affiliated-Individuation in Caregivers of Adults with Dementia

The purpose of this study was to test the effect of a theory-based support group intervention on afftliated-individuation in caregivers of adults with dementia. Modeling and Role-Modeling, a theory and paradigm for nursing, provided the framework for intervention. The sample of 26 caregivers attended biweekly support groups for 12 months. Quantitative data, collected at baseline and at 6 and 12 months, were analyzed using MANOVA to assess withinsubject variance. Results of data analysis indicated that levels of affiliated individuation did not decrease in the subjects in spite of their continued caregiving of persons who had Alzheimer's disease. Qualitative data collected 1–2 months after 12 months of interventions supported the quantitative findings. They also described a process that parallels the theoretical definition of affiliated-individuation.     

Social Networks of Women Caregivers

Abstract Social networks and the support that network members provide are important resources for family caregivers in sustaining their caregiving role. Caregivers' perceptions of support from family and friends have been linked to their health status (R. Kahn & T. Antonucci, 1980; I. Sandler & M. Barrera, 1984). The purpose of this study was to explore the social networks and types of perceived support described by women who are caregivers of cognitively impaired older adults. Content analysis was used to examine interview data from a longitudinal qualitative study of 20 women caregivers of cognitively impaired older persons. An important finding of this study was the identification of a typology of social networks of the women caregivers. The caregivers' perceptions of satisfaction with support received and experience of conflict with network members varied according to the characteristics of their social network. Those caregivers who belonged to diverse social networks reported high satisfaction with the support that they received and little or no conflict. Those caregivers with kin-dominated social networks reported little satisfaction with support received and a high degree of conflict.     

A Mindful Eating Group Intervention for Obese Women: A Mixed Methods Feasibility Study

The purpose of this mixed methods study was to: 1) describe the effect of an 8-week mindful eating intervention on mindful eating, weight loss self-efficacy, depression, and biomarkers of weight in urban, underserved, obese women; and 2) identify themes of the lived experience of mindful eating. A convenience sample of 12 obese women was recruited with data collected at baseline and 8 weeks followed by a focus group. Only self-efficacy for weight loss significantly increased over 8 weeks (t = − 2.63, P = .04). Qualitative findings of mindful eating supported quantitative findings and extended understanding about the effect of the intervention.     

Family Caregivers for People with Dementia and the Role of Occupational Therapy

ABSTRACT. As the population continues to age, the prevalence of Alzheimer's disease and related dementia (ADRD) will increase, along with the number of informal (e.g., family and friends) caregivers needed. The negative physical, mental, and financial impact providing such care has on the caregiver, in addition to the tremendous economic value of their care, has been well documented. Furthermore, the quality of care and the amount of care that is provided has also been shown to influence the overall health and wellbeing of the care receiver and caregiver. The current qualitative, phenomenological study explored the experience of these family caregivers and how occupational therapists can better assist caregivers for people who have dementia. Five themes emerged: Personal Changes, Obstacles/Challenges, Support Network, Emotions, and Healthcare Thoughts. A discussion of the themes and how occupational therapists can assist these caregivers is included.     

The Use of Modified Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy Program for Family Caregivers of People Living with Dementia: A Feasibility Study

PurposeThe aim of this study was to investigate the feasibility and preliminary efficacy of a modified mindfulness-based stress reduction (MBSR) program and mindfulness-based cognitive therapy (MBCT) program for reducing the stress, depressive symptoms, and subjective burden of family caregivers of people with dementia (PWD).MethodsA prospective, parallel-group, randomized controlled trial design was adopted. Fifty-seven participants were recruited from the community and randomized into either the modified MBSR group (n = 27) or modified MBCT group (n = 26), receiving seven face-to-face intervention sessions for more than 16 weeks. Various psychological outcomes were measured at baseline (T0), immediately after intervention (T1), and at the 3-month follow-up (T2).ResultsBoth interventions were found to be feasible in view of the high attendance (more than 70.0%) and low attrition (3.8%) rates. The mixed analysis of variance (ANOVA) results showed positive within-group effects on perceived stress (p = .030, Cohen's d = 0.54), depressive symptoms (p = .002, Cohen's d = 0.77), and subjective caregiver burden (p < .001, Cohen's d = 1.12) in both interventions across the time points, whereas the modified MBCT had a larger effect on stress reduction, compared with the modified MBSR (p = .019).ConclusionBoth the modified MBSR and MBCT are acceptable to family caregivers of PWD. Their preliminary effects were improvements in stress, depressive symptoms, and subjective burden. The modified MBCT may be more suitable for caregivers of PWD than the MBSR. A future clinical trial is needed to confirm their effectiveness in improving the psychological well-being of caregivers of PWD.     

An Interprofessional Virtual Healthcare Neighborhood for Caregivers of Elderly With Dementia

Healthcare websites are vital resources for individuals with limited access to healthcare. The 6 million United States citizens with dementia and their caregivers are an example of a population in need of the assistance provided by interactive websites. Dementia often confines the patient and caregiver to the home, thus creating caregiver burden and stress that often results in institutional care. This article describes the nurse practitioner‒developed Virtual Healthcare Neighborhood, a web-based platform. The Virtual Healthcare Neighborhood provides an interprofessional approach to using technology to provide education, peer support, and healthcare consultation to caregivers of homebound older adults with dementia.     

老年痴呆照顾者对虐待老人认知的定性研究

目的深入了解老年痴呆照顾者对虐待老人的认知,为制定有针对性的干预措施提供依据。方法采用现象学研究方法,对10名老年痴呆家庭照顾者和8名机构照顾者进行深度访谈,运用Colaizzi的关于现象学资料的7步分析法分析资料。结果老年痴呆照顾者对虐待老人的认知可归纳为以下4个主题:(1)对虐待老人的理解局限,以有意的打骂和疏于照顾为主;(2)虐待老人的原因多为孝心、责任心缺失;(3)应通过自我约束减少虐待;(4)对虐待老人的危害性认识不足,大多以可见的躯体伤害为主,对痴呆患者受虐感知不确定。结论老年痴呆照顾者能够认识到虐待老人是错误行为,但对其缺乏全面的认识。对此,应加大相关知识的宣传力度,明确"虐待老人"的定义,提高痴呆照顾者对虐待老人的认知,通过法律和社会支持,减少虐待行为的发生。     

A Mixed Methods Evaluation of the Feasibility and Acceptability of an Adapted Cardiac Rehabilitation Program for Home Care Patients

Home care clinicians have an opportunity to improve care for post-hospitalization patients with cardiovascular disease. This mixed methods study examined the feasibility and acceptability of an adapted cardiac rehabilitation (CR) program for the home care setting. Surveys measuring patient self-care and knowledge were administered to patients (n = 46) at baseline and at 30-day follow-up. Semi-structured interviews were conducted with patients (n = 28) and home care clinicians (n = 11) at completion of the program. All survey indicators demonstrated a trend towards improvement, with a statistically significant increase in the self-care management subscale (p = 0.002). Qualitative analyses identified three patient themes (self-awareness, nutrition, motivation) and three clinician themes (systematic approach, motivation, patient selection process). Incorporating CR into the home care setting proved to be a feasible and acceptable approach to increasing access to CR services among elderly patients.     

Coping Skills Training and Acceptance and Commitment Therapy for Symptom Management: Feasibility and Acceptability of a Brief Telephone-Delivered Protocol for Patients With Advanced Cancer

ContextPatients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers—availability of interventions in community clinics as well as financial and illness-related factors—to accessing psychosocial interventions.ObjectivesThe aim of the present study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer.MethodsAdult patients with advanced cancer receiving care in the community received Engage, four 60-minute manualized telephone sessions delivered by a trained psychotherapist and completed pretreatment and post-treatment assessments.ResultsEngage was feasible, achieving 100% accrual (N = 24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean 29 of 32; SD 2), engagement (95% attendance), and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity after treatment.ConclusionEngage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.     

Caregiving Experience of Dementia among Korean American Family Caregivers

Dementia is a major public health problem affecting 5.5 million people in USA. This qualitative study explored the caregiving experience of Korean American (KA) families of persons with dementia (PWD). Adult KA caregivers of PWD (n?=?18) were recruited for semi-structured interviews. Thematic analysis yielded four themes: challenges in finding resources, struggling with mental health issues, traveling the path of acceptance, and finding ways to survive. Due to the language barrier, most KA caregivers reported using Korean Internet for information on dementia and caregiving. Some traveled to South Korea seeking medical assistance for dementia (medical tourism). Importantly, some KA caregivers expressed suicidal thoughts and depression. Unexpectedly, familism prevented help seeking and possible relief from their difficulties. There is an urgent need to improve access to dementia care services and education for the KA community. Building a trusting relationship with healthcare providers is even more important for KA caregivers to address their mental health concerns.