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1.
Purpose
To compare intakes of dietary iron and enhancers and inhibitors of iron absorption between overweight/obese (OW/OB) adolescents and their normal weight (NW) peers, and between parental education levels stratified by weight status.Methods
This was a comparative cross-sectional study of adolescents (n 121 OW/OB and n 102 NW) aged 12–14 years, attending a secondary school in Nonthaburi province, Thailand. Socio-demographic data were obtained from participants’ parents using a questionnaire. Participants recorded their intakes for 3 non-consecutive days, using a prospective food record.Results
Compared with NW adolescents, OW/OB adolescents consumed more total protein and animal protein after adjustment for energy intake (both p = 0.047). OW/OB adolescents whose mothers were less educated consumed more total iron and available iron after adjustment for energy intake, compared with their OW/OB peers whose mothers were more educated (p = 0.045 and p = 0.040). NW adolescents with more highly educated mothers had higher absolute and energy-adjusted fibre intakes (both p = 0.047). However, NW adolescents of mothers with a high–intermediate level of education consumed less calcium, after adjustment for energy intake (p = 0.028).Conclusions
OW/OB adolescents with less educated mothers had higher energy-adjusted intakes of iron and available iron. Dietary differences in OW/OB adolescents relative to maternal education, and other socioeconomic indicators, should be explored in a nationally representative data set.2.
Nunzia Rainone Alessandro Chiodi Roberta Lanzillo Valeria Magri Anna Napolitano Vincenzo Brescia Morra Paolo Valerio Maria Francesca Freda 《Quality of life research》2017,26(3):727-736
Purpose
To investigate the moderating role of resilience in the relationship between affective disorders and Health-Related Quality of Life (HRQoL) for adolescents and young adults with multiple sclerosis (MS).Methods
A quantitative methodology was adopted. Fifty-three adolescents and young adults were interviewed to assess resilience as a personality trait (Ego-Resiliency Scale) and resilience as an interactive competence (CYRM-28), Health-Related Quality of Life (PedsQL 4.0), depression and anxiety (BDI-II and STAI-Y).Results
Affective disorders, both depression (β = ?.38, p < .001) and anxiety (State β = –.35, p < .001; Trait β = ?.41, p < .001), were negatively associated with HRQoL. Data also showed that the resilience competencies using Individual (β = .22, p < .001) and relational resources (β = .12, p < .05) are significantly associated HRQoL. According to the regression analyses, we tested the moderating role of resilience competence using individual resources on the relationship between the Depression Cognitive Factor and Emotional Functioning. Data show that in step 2 of the regression analysis, we obtained a variation of β = ?.45 (p < .001) to β = ?.30 (p < .001) in the dimension for the Depression Cognitive Factor. The Sobel test showed that the moderating effect of resilience was significant regarding the increase in R2 (p < .01).Conclusions
Resilience competence using individual resources moderates the relationship between the Depression Cognitive Factor and Emotional Functioning in adolescents with MS. Our study suggests that to improve well-being for adolescents with MS resilience could play a key role.3.
Theresa Katharina Schäfer Christoph Herrmann-Lingen Thomas Meyer 《Quality of life research》2016,25(12):3077-3086
Objective
Numerous studies have linked vitamin D to health-related quality of life (hrQoL) in chronically ill adults or elderly subjects. The aim of this study was to evaluate the association between 25-hydroxyvitamin D (25(OH)D) and hrQoL in a population-based sample of German adolescents.Methods
A total of n = 5066 study participants from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (Kinder- und Jugendgesundheitssurvey) aged 11–17 years were included in this post hoc analysis. HrQoL was measured using the well-validated self- and parent-rated Children’s Quality of Life questionnaires (KINDL-R), while the level of distress was assessed using the self- and proxy version of the Strengths and Difficulties Questionnaire (SDQ). Serum 25(OH)D concentrations were determined using a commercially available chemiluminescence immunoassay.Results
Bivariate analyses demonstrated a significant positive association between 25(OH)D and hrQoL for both self- [estimate (E) = 0.82, 95 % confidence interval (95 % CI) 0.35–1.30, p = 0.001] and parent ratings (E = 1.33, 95 % CI 0.83–1.83, p < 0.001). In addition, we found negative correlations between 25(OH)D and self- (E = ?0.34, 95 % CI ?0.58 to ?0.11, p = 0.005) and parent-reported total SDQ scores (E = ?0.70, 95 % CI ?1.03 to ?0.37, p < 0.001). Generalized linear models adjusted for age, sex, body mass index, systolic blood pressure, migration background, socio-economic status, and sedentary screen time confirmed that 25(OH)D independently and significantly predicted better hrQoL (p ≤ 0.004).Conclusions
These findings linking 25(OH)D to better well-being in a nationally representative sample of German children and adolescents suggest beneficial effects of vitamin D on mental health. However, recommendations for vitamin supplementation in healthy children and adolescents are not warranted from our data.4.
Objective
Children with life-threatening medical conditions frequently undergo invasive medical procedures that may elicit anxiety and distress. However, there are few empirically validated interventions that reduce mental health symptoms and increase the resilience of children during the acute stages of illness. This study aimed to evaluate the efficacy of the Make a Wish intervention for children with life-threatening cancer.Methods
The design was a wait-list-controlled trial with two parallel groups. Sixty-six children aged 5–12 with an initial diagnosis of life-threatening cancer were identified and randomly assigned to the Make a Wish intervention (n = 32) or a wait-list control group (n = 34). Children completed measures of psychiatric and health-related symptoms, positive and negative affect, hope, and optimism pre-intervention and post-intervention. After baseline data collection, children were interviewed and made an authentic wish that they wanted to come true. These wishes were made possible 5–6 months after baseline data collection, to fuel anticipation and excitement over the wish-fulfillment event. The post-intervention assessment point was 5 weeks after wish fulfillment (approximately 7 months after baseline data collection).Results
Children in the intervention group exhibited a significant reduction in general distress (d = 0.54), depression (d = 0.70), and anxiety symptoms (d = 0.41), improved health-related quality of life (d = 0.59), hope (d = 0.71), and positive affect (d = 0.80) compared to decrease in positive affect and no significant changes in the other measures in the control group.Conclusions
These findings emphasize the role of hope and positive emotions in fostering the well-being of children who suffer from serious illnesses.5.
Hui-Ing Ma Marie Saint-Hilaire Cathi A. Thomas Linda Tickle-Degnen 《Quality of life research》2016,25(12):3037-3045
Purpose
People with Parkinson’s disease (PD) may experience stigma due to their visible features of movement and communication difficulties. This paper aimed to examine the role of experienced stigma in health-related quality of life (QOL), after controlling for personal and clinical characteristics.Methods
This is a preliminary analysis of a subset of baseline data from the Social Self-Management of Parkinson’s Disease Study (SocM-PD), an ongoing 3-year prospective cohort study. Seventy-three people with PD (M age = 65.72, 29 women) participated in this study. Hierarchical multiple regression analyses were used to determine the role of stigma in QOL, after controlling for gender, disease severity, depression, and motor difficulties of daily living.Results
Significant correlations were found between QOL with gender (r = .26), disease severity (r = .38), depression (r = .65), motor difficulties of daily living (r = .71), and stigma (r = .83). After controlling for the significant covariates, stigma made a significant and unique contribution to the explanation of QOL by 13.7 % (p < 0.001). A final hierarchical multiple regression with stigma and the 4 covariates revealed an overall model that explained 77.8 % of the total variance of QOL (F [5, 63] = 48.79, p < 0.001).Conclusions
Experienced stigma appears to be a key determinant of QOL in people with PD. The results suggest the importance of further understanding stigma in PD to develop possible intervention strategies. Future work is also needed to verify the results with a larger and longitudinal dataset of the SocM-PD.6.
Jazmin A. Reyes-Portillo Erica M. Chin Josefina Toso-Salman J. Blake Turner David Vawdrey Laura Mufson 《Child & youth care forum》2018,47(3):391-402
Background
No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into the clinical care of youth at-risk for suicide.Objective
This study aimed to examine the feasibility and acceptability of using an EHR alert to increase clinicians’ use of safety planning with youth at-risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community.Methods
An alert intervention was developed to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished visit documentation.Results
There were 69 at-risk patients between the ages of 13–21 in the intervention period (M = 15.71; SD = 1.86; 66.7% female) and 64 (M = 15.38; SD = 1.93; 68.6% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p < .01). The pattern of results remained the same after adjusting for demographic variables (p = .01). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert, indicating moderate satisfaction (M = 3.01; SD = 0.63; range = 1.11–4.11).Conclusions
EHR alerts are associated with changes in clinicians’ behavior and improved compliance with best clinical practices for at-risk youth.7.
Objective
The present study investigated the reinforcing value of healthy and unhealthy snack food in adolescents (n = 108, aged 14–16 years). Moderation by access to different foods, sex and the personality trait reward sensitivity is tested.Methods
In a computerized Food Reinforcement Task, adolescents could earn portions of a healthy and an unhealthy snack following an identical progressive reinforcement schedule for both food types. Reinforcing value of food was indexed by the number of button presses for each food type. Participants were allocated randomly to two-order condition: fruit–snack versus snack–fruit. Reward sensitivity was assessed with the Dutch age-downward version of Carver and White’s BIS/BAS scale.Results
Results showed that the reinforcing value of an unhealthy snack is higher than that of fruit, with participants making more button presses for unhealthy snacks, M = 1280.40, SD = 1203.53, than for fruit, M = 488.04, SD = 401.45, F(1,48) = 25.37, p < 0.001. This effect is stronger in boys (β = ?1367.67) than in girls (β = ?548.61). The effect is only present in the snack–fruit condition, not in the fruit–snack condition, indicating that access to food moderates the effect of food type. There is no evidence for moderation by reward sensitivity.Conclusions
Results point to the importance of simultaneously increasing barriers to obtain unhealthy food and promoting access to healthy food in order to facilitate healthy food choices.8.
Purpose
Work-related factors are one of the known risk factors for depression. Given that the ability to work is considered an important aspect of well-being and health status, we investigated the association between the loss of work ability and depression. We further examined the association stratified by employment status.Methods
We used data from the Korea Welfare Panel Study. The dependent variable of the present study was depression, which is measured by the Center for Epidemiologic Studies Depression Scale. Work ability transition from the previous year was divided into three categories: maintained, loss, and complete loss. A linear mixed-effects model was performed for the analysis.Results
The work ability loss group (β = 2.071, p < 0.0002) and the work ability completely loss group (β = 2.651, p = 0.015) had higher depression scores compared to those who maintained their work ability from the previous year. Specifically, those who lost their work ability and their job (β = 3.685, p = 0.0068) had the highest depression scores compared to those who maintained their work ability and job.Conclusions
We found that those who lost their ability to work may be at risk of depression, and this finding was particularly prominent among those who also became unemployed. Therefore, psychological support is needed for these individuals to overcome the negative influence of the loss of work ability.9.
Objectives
Psychosocial factors are important determinants of an individual’s health. This study examines the association between health scores and social network factors on mental health across different life stages.Methods
Data were drawn from the Household Income and Labour Dynamics in Australia survey for adolescents (n = 1739), adults (n = 10,309) and seniors (n = 2287). Hierarchical regression modelling was applied to examine effects within and across age groups. All the variables were derived from the self-completion questionnaire.Results
The social network factors were statistically significant predictors of mental health outcomes for all three life stages. For adolescents, the three social network factors were statistically significant with social isolation having the largest impact (β = ?.284, p < .001), followed by social connection (β = .084, p < .001) and social trust having a similar effect (β = .073, p < .001). For adults social isolation had the highest impact (β = ?.203, p < .001), followed by social connection (β = .110, p < .001) and social trust (β = .087, p < .001).The results for seniors were social isolation (β = ?.188, p < .001), social connection (β = .147, p < .001) and social trust (β = .032, p < .05).Conclusions
After adding the social network factors, the models improved significantly with social isolation playing the most significant role across all life stages, whereas the other social network factors played a differentiated role depending upon the life stage. These findings have practical implications in the design of mental health interventions across different life stages.10.
L. Claassens C. B. Terwee D. J. H. Deeg M. I. Broese van Groenou G. A. M. Widdershoven M. Huisman 《Quality of life research》2016,25(4):859-870
Purpose
In response to the increased emphasis placed on older people’s self-reliance in many welfare societies, we aimed to develop and validate a measurement instrument, assessing perceived control in health care among older adults with care needs. The target group consists of older people who live (semi-)independently and use professional health care, with or without informal care.Methods
Phase I (development) of the study consisted of the construction of the instrument based on the input from a variety of stakeholders. Phase II (validation) entailed a quantitative study in a sample of 247 respondents selected from the Longitudinal Aging Study Amsterdam, to assess the instrument’s construct validity (structural validity and hypotheses testing) and reliability (internal consistency).Results
The questionnaire consists of 29 items, related to organizing professional care, communication with care professionals, health management in the home situation, planning (more) complex care in the future, and perceived support from the social network. Based on a factor analysis, we identified three subscales: (I.) ‘perceived personal control in health care’; (II.) ‘anticipated personal control regarding future health care’; and (III.) ‘perceived support from the social network,’ with internal consistencies varying from Cronbach’s α = .71 to .90. Factor I was associated with mastery, self-efficacy, self-esteem (r = .31–.35) and factor III with social loneliness (r = ?.42). Factor II correlated less strongly with mastery, self-efficacy, and self-esteem (r < .30).Conclusion
Our questionnaire revealed sufficient construct validity and internal consistency. The instrument provides a basis for further quantitative research regarding control, especially in relation to health care-related outcomes.11.
Mustafa Turgut Yıldızgören Türkan Nadir Öziş Ali Erdem Baki Engin Tutkun Hınç Yılmaz Tülay Tiftik Timur Ekiz Neşe Özgirgin 《Environmental health and preventive medicine》2016,21(3):149-153
Objective
The purpose of the study was to evaluate the bone mineral density (BMD) and 25-hydroxyvitamin D (25(OH)D) levels in patients with silica exposure.Materials and methods
The study included 104 male subjects with silica exposure and 36 healthy subjects. Posterior–anterior radiographs were classified according to the International Labour Office (ILO) Classification. Category 0 patients were classified as Group I (n = 54), category I patients were classified as Group II (n = 25), Category II and III patients were classified as Group III (n = 25).Results
Femoral neck BMD values were significantly lower in Group III (p = 0.007). Lumbar vertebrae BMD values were significantly lower in all groups with silica exposure than in the control group (p = 0.000). The osteoporosis rate was significantly higher in Group III (p = 0.000). Subjects with silica exposure were determined to have diminished 25(OH)D levels (p = 0.012).Conclusion
The results of this study demonstrated that subjects with silica exposure have diminished BMD and 25(OH)D levels.12.
Background
To validate the physical activity (PA) questionnaire in Nord-Trøndelag Health Study (HUNT 2).Methods
The questionnaire was administered twice to a random sample of 108 men aged 20–39 and validity by comparing results with VO2max and ActiReg, measuring PA and energy expenditure and with the International Physical Activity Questionnaire (IPAQ).Results
Spearman correlation coefficients indicated poor and moderate significant agreement by test-retest (light activity, r = 0.17, and hard activity, r = 0.50). We found a moderate significant correlation r = 0.46 (p ≤ 0.01) between hard PA and VO2max and n.s for light activity (r = ?03). Metabolic equivalent (METs) values 6+ from ActiReg most strongly correlated with hard PA r = 0.31 (p ≤ 0.01), though associations of other measures obtained from ActiReg with questionnaire measures were weaker. Occupational activity was strongest correlated for METs 3–6 r = 0.48 (p ≤ 0.01) by ActiReg.Conclusions
The HUNT 2 question for “hard” LTPA has acceptable repeatability and appears to be a reasonably valid measure of vigorous activity, as reflected in moderate correlations with several other measures including VO2max, and with corresponding results from IPAQ and ActiReg. The HUNT 2 question on occupational activity had good repeatability and appears to best reflect time spent in moderate activity, with moderate associations with measured time at intermediate intensity levels. The “light” activity question from HUNT 2 had poor reproducibility and did not correlate well with most of the comparison measures. Thus, the “hard” PA and the occupational activity question should be useful measures of vigorous PA, if time and space allow only very brief assessment. The utility of the “light” PA questions remains to be established.13.
14.
Ana Aparecida Tessari Maruí Weber Corseuil Giehl Ione Jayce Ceola Schneider David Alejandro González-Chica 《Quality of life research》2016,25(12):3057-3066
Purpose
To analyze the effects of anthropometric measures change on quality of life (QoL) in elderly, using measured anthropometric data on body mass index (BMI) and waist circumference (WC).Method
Population-based cohort study investigating a sample of elderly (≥60) assessed in 2009 (n = 1705) and followed up in 2013 (n = 1197). QoL was evaluated in 2013 using the CASP-19. Variables evaluated as exposure including BMI and WC in 2009 (both standardized), categories of anthropometric measures change from 2009 to 2013 (excess weight = BMI ≥ 25.0 kg/m2; large WC = top quartile), and the absolute BMI and WC change in same period. Multivariate linear regressions adjusted for possible confounding factors and mediators were used.Results
Both BMI and WC at baseline were associated with lower QoL scores, even after adjustment for confounding variables (β BMI = ?0.9; 95 % CI ?1.5; ?0.3 and β WC = ?1.0; 95 % CI ?1.7; ?0.4). Additionally, QoL scores were lower among elderly with excess weight (β = ?1.4; 95 % CI ?2.9; 0.0) or large WC (β = ?3.3; 95 % CI ?5.2; ?1.4) in both waves than among those whose BMI and WC were always normal, but changes in anthropometric measures did not affect QoL. The presence of chronic diseases was a partial mediator of these associations, especially for effects of BMI change. Anthropometric measures change treated as a continuous variable was not associated with QoL.Conclusions
Having excess weight and large WC in both waves was associated with lower QoL scores in elderly, but changing the anthropometric measures did not affect this outcome. Maintaining weight and WC within normal limits during aging can help to preserve QoL.15.
Purpose
Alcoholic liver disease or non-alcoholic fatty liver disease/non-alcoholic steatohepatitis are well-known risk factors for liver fibrosis or cirrhosis and hepatocellular carcinoma; it is a major global health concern, but there are few effective and safe management options. Therefore, we aimed to investigate the effects of fermented garlic extracts (FGEs) on hepatic function in adults with mild hepatic dysfunction without underlying hepatic disease.Methods
In this double-blind, randomized, placebo-controlled study, seventy-five adults with elevated serum gamma-glutamyl transpeptidase (GGT) levels were included in a FGE-administered group (n = 36) or a placebo group (n = 39), and received either two sachets/day containing FGEs or placebo over a 12-week period. Primary endpoint was the change in serum GGT levels. Data were analysed using a generalized linear mixed effects model.Results
Significant group × time interactions for serum levels of GGT (F = 3.98, P = 0.022) and alanine aminotransferase (ALT; F = 3.28, P = 0.043) were observed with an improvement in levels of GGT (P = 0.066) and ALT (P = 0.014) in the FGE group compared to that reported for the placebo group at the 12-week visits. There was no intergroup difference in the prevalence of adverse events.Conclusions
Intake of FGEs improved serum GGT and ALT levels in adults with mildly elevated serum GGT level without reported adverse side effects. FGEs might be effective and safe management options for mild hepatic dysfunction.16.
Pia Näsvall Ursula Dahlstrand Thyra Löwenmark Jörgen Rutegård Ulf Gunnarsson Karin Strigård 《Quality of life research》2017,26(1):55-64
Aim
Health-related quality of life (HRQoL) assessment is important in understanding the patient’s perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma.Methods
711 patients operated for rectal cancer with abdomino-perineal resection or Hartman’s procedure and a control group (n = 275) operated with anterior resection were eligible. Four QoL questionnaires were sent by mail. Comparisons of mean values between groups were made by Student´s independent t test. Comparison was made to a Swedish background population.Results
336 patients with a stoma and 117 without stoma replied (453/986; 46 %). A bulging or a hernia around the stoma was present in 31.5 %. Operation due to parastomal hernia had been performed in 11.7 % in the stoma group. Mental health (p = 0.007), body image (p < 0.001), and physical (p = 0.016) and emotional function (p = 0.003) were inferior in patients with stoma. Fatigue (p = 0.019) and loss of appetite (p = 0.027) were also more prominent in the stoma group. Sexual function was impaired in the non-stoma group (p = 0.034). However in the stoma group, patients with a bulge/hernia had more sexual problems (p = 0.004). Pain was associated with bulge/hernia (p < 0.001) and fear for leakage decreased QoL (p < 0.001). HRQoL was impaired compared to the Swedish background population.Conclusion
Overall HRQoL in patients operated for rectal cancer with permanent stoma was inferior compared to patients without stoma. In the stoma group, a bulge or a hernia around the stoma further impaired HRQoL.17.
Chiara S. Haller Colin M. Bosma Kush Kapur Ross Zafonte Ellen J. Langer 《Quality of life research》2017,26(4):893-902
Objective
The objective of the present investigation was to examine the association of mindful creativity with the trajectory of recovery (emotional, interpersonal, cognitive, and total functioning) of patients with severe TBI.Methods
This was drawn from a subsample of an adult prospective cohort study on severe TBI in Switzerland; patients and their relatives were assessed at 3, 6, and 12 months (patients N = 176, relatives N = 176). Predictor measures were assessed using Mindful Creativity Scale—short form and time (trajectory of functioning of the patient over time). Outcome measures were assessed using Patient Competency Rating Scale for Neuro-rehabilitation (PCRS-NR; measuring emotional, interpersonal, cognitive, and total functioning post-injury). All measures were assessed at each time point. Mixed linear models were run separately for ages >50 and ≤50 (i.e., bimodal distribution).Results
Patients’ mindful creativity showed no significant association with patients’ functioning across time in any of the models. In all age groups, interpersonal functioning decreased across time (slope>50 = ?4.66, p = .037; slope≤50 = ?7.19, p = .007). Interestingly, in age group ≤50, interpersonal functioning increased when looking at relative mindful creativity by time (slope = 1.69, p = .005). Additionally, relatives mindful creativity was significantly associated with patients’ functioning in age group ≤50: (a) patients’ total functioning (slope = 0.18, p = .03) and (b) cognitive functioning (slope = 0.72, p = .020).Conclusions
Relatives’ mindful creativity was significantly associated with patients’ functioning after severe TBI. Implications for treatment and future research are discussed.18.
Purpose
Caffeine-containing energy drinks (EDs) are currently used as ergogenic aids to improve physical performance in a wide variety of sport disciplines. However, the outcomes of previous investigations on this topic are inconclusive due to methodological differences, especially, in the dosage of the active ingredients and the test used to assess performance.Methods
We performed a systematic review and meta-analysis of published studies to evaluate the effects of acute ED intake on physical performance. The search for references was conducted in the databases PubMed, ISI Web of Knowledge and SPORTDiscus until December 2015.Results
Thirty-four studies published between 1998 and 2015 were included in the analysis. Using a random-effects model, effect sizes (ES) were calculated as the standardized mean difference. Overall, ED ingestion improved physical performance in muscle strength and endurance (ES = 0.49; p < 0.001), endurance exercise tests (ES = 0.53; p < 0.001), jumping (ES = 0.29; p = 0.01) and sport-specific actions (ES = 0.51; p < 0.001), but not in sprinting (ES = 0.14; p = 0.06). The meta-regression demonstrated a significant association between taurine dosage (mg) and performance (slope = 0.0001; p = 0.04), but not between caffeine dosage (mg) and performance (slope = 0.0009; p = 0.21).Conclusion
ED ingestion improved performance in muscle strength and endurance, endurance exercise tests, jumping and sport-specific actions. However, the improvement in performance was associated with taurine dosage.19.
Isabel Mosquera Itziar Vergara Mónica Machón Carlos Calderón 《Quality of life research》2016,25(5):1059-1092
Purpose
To classify and identify the main characteristics of the tools used in practice to assess the impact of elderly caregiving on the informal carers’ life.Methods
A systematic review of literature was performed searching in Embase, MEDLINE, PsycINFO, CINAHL, IBECS, LILACS, SiiS, SSCI and Cochrane Library from 2009 to 2013 in English, Spanish, Portuguese and French, and in reference lists of included papers.Results
The review included 79 studies, among them several in languages other than English. Their inclusion increased the variety of identified tools to measure this impact (n = 93) and allowed a wider analysis of their geographical use. While confirming their overlapping nature, instruments were classified according to the degree of integration of dimensions they evaluated and their specificity to the caregiving process: caregiver burden (n = 20), quality of life and well-being (n = 11), management and coping (n = 21), emotional and mental health (n = 29), psychosocial impact (n = 10), physical health and healthy habits (n = 2), and other measures. A high use in practice of tools not validated yet and not caregiver-specific was identified.Conclusions
The great variety and characteristics of instruments identified in this review confirm the complexity and multidimensionality of the effects of elderly caregiving on the informal carer’s life and explain the difficulties to assess these effects in practice. According to the classification provided, caregiver burden and emotional and mental health are the most evaluated dimensions. However, further work is required to develop integrated and caregiving focused procedures that can appraise this complexity across different countries and cultures.20.