Differences between and within genders in caregiving strain: a comparison between caregivers of demented and non-caregivers of non-demented elderly people

Differences between and within genders in caregiving strain: a comparison between caregivers of demented and non-caregivers of non-demented elderly people Fifty-two caregivers for demented and 66 non-caregivers for non-demented elderly were investigated both within a gender and between genders. All participants were relatives and a burden questionnaire was used. The results showed that there was not always a difference between the caregivers for demented and the non-caregivers for non-demented elderly which may indicate that being a relative , even to a non-demented elderly, has obviously its own problems and importance. However, results showed more significant differences between female caregivers and female non-caregivers than between male caregivers and male non-caregivers, with females caring for a demented elderly suffering most strain. Their strain was exhibited by health problems, conflicts in the family, strained relations with family and others, a less positive outlook and limits in social support because of the caregiving situation. When investigating the group of male caregivers and male non-caregivers, it was found that males caring for a demented elderly person experienced a lack of positive outlook and a need for social support. The elderly person's residence in the group of caregivers for demented elderly people and in the group of non-caregivers for non-demented elderly people did not, however, appear to indicate any significant differences.     

Burnout of caregivers: a comparison between partners of psychiatric patients and nurses

Care of a person with mental illness involves multiple burdens, possibly leading to burnout. This study compares partners of persons with schizophrenia and depression with nursing staff based on dimensions of burnout. Nursing staff and partners of patients with schizophrenia or depression were consecutively recruited from psychiatric hospitals and interviewed with the Maslach Burnout Inventory. No significant differences were found in the three dimensions of burnout (emotional exhaustion, depersonalization, and personal accomplishment) for the two groups of caregivers. About one fourth of the respondents in both groups showed a high degree of burnout. Professional and nonprofessional caregivers face a similar degree of burden and need support to perform their caretaking tasks.     

The influence of end-of-life cancer care on caregivers

The purpose of this secondary analysis was to glean from prospective data whether those caring for elderly family members recently diagnosed with cancer who ultimately died reported different caregiver depressive symptomatology and burden than caregivers of those who survived. Findings from interviews with 618 caregivers revealed that caregiver depressive symptomatology differed based on family members' survival status, and spousal caregivers experienced greater burden when a family member was near death than did non-spousal caregivers. Family member symptoms and limitations in daily living, as well as caregiver health status, age, and employment, were associated with caregiver depressive symptomatology and burden; however, these associations had no interaction with family member survival status.     

老年人家庭照顾者身体健康状况与照顾负担的关系分析

目的：探讨老年人家庭照顾者自身的身体健康状况及与照顾负担的关系。方法采用Zarit照顾者负担量表调查1517名老年人家庭照顾者负担情况,同时调查人口学资料及健康状况,分析不同健康状况的老年人家庭照顾者的照顾负担情况。结果本次调查的老年人家庭照顾者中有61．0％（926/1517）有明确诊断的疾病,77．5％有自我感觉不适症状,10．8％自我健康评价水平低。926名有疾病的老年人家庭照顾者中轻、中、重度照顾负担的比例分别为35．3％,18．5％,4．4％,高于无明确诊断疾病者（分别为31．5％,10．7％,2．7％）,差异有统计学意义（Z＝-5．632,P＜0．01）。有自我感觉不适症状的老年人家庭照顾者轻、中、重度照顾负担分别为35．7％,16．7％,4．4％,高于无症状者（分别为27.5％,11．1％,1．5％）,差异有统计学意义（Z＝-5．573,P＜0．01）。不同自我健康评价水平的老年人家庭照顾者间差异无统计学意义（P＞0．05）。结论身体健康状况差的老年人家庭照顾者照顾负担重,护理人员应重视其身体健康状况,提供照顾相关知识和技能,缓解照顾压力。     

老年公寓中老年人主观幸福感和护理员工作倦怠关系的相关性研究

[目的]探讨老年公寓中老年人的主观幸福感与护理员工作怠倦之间的关系。[方法]应用纽芬兰纪念大学幸福度量表和工作倦怠量表对150例老年人和102例护理员进行调查分析,采用 Pearson相关和逐步回归分析探讨二者之间的关系。[结果]老年公寓老年人的主观幸福感得分为（32.73±11.47）分,处于中等水平;护理员工作倦怠得分为（4.33±1.23）分。护理员中25.5%有轻中度倦怠,74.5%的有重度倦怠。老年人主观幸福感与护理员工作倦怠总分没有相关性,但与情绪衰竭维度和玩世不恭维度有相关性（P〈0.05）。多元线性逐步回归分析显示,身体状况、对公寓的满意度、家庭关系、情绪衰竭、玩世不恭及家庭住址进入回归方程。[结论]老年公寓中老年人的主观幸福感处于中等水平,身体状况、对公寓的满意度及家庭关系不和是影响老年人主观幸福感的因素;老年人主观幸福感和护理员工作倦怠总分没有相关性,但护理员的不良情绪以及玩世不恭的态度可影响老年人的幸福体验。因此,要从老年人自身、公寓管理者及健康照顾者的综合角度入手,以提高老年人的主观幸福感。     

Relationships between income, subjective health and caregiver burden in caregivers of people with dementia in group living care: a cross-sectional community-based study

BACKGROUND: Family caregivers of relatives with dementia report higher level of psychological distress than other caregivers and report their self-related health as poorer than that of comparison groups. AIMS AND OBJECTIVES: The purpose of the study was to examine characteristics of family caregivers and to assess whether income, subjective health, age and relationship were associated with the burden of care they experienced. SETTING: Group living units in southern Sweden. PARTICIPANTS: Fifty caregivers who served as informal caregivers of relatives with dementia in group living care. DESIGN: Interviews regarding economic and social conditions and well-evaluated scales for health and caregiver burden (CB) were used. RESULTS: The majority of the family caregivers were adult children, and twice as many were female than were males. The investigation showed that total burden, strain and disappointment, adjusted for health and age, were related to income. Disappointment showed a relation to subjective health. The adult children showed a significantly higher degree of total burden, irrespective of age, compared to other family caregivers. Low income was associated with a higher degree of burden among adult children. However, elderly participants experienced less of burden than younger ones. CONCLUSION: Our findings indicate that caregivers with low health profile and low income, especially adult children, are associated with higher CB. RELEVANCE TO CLINICAL PRACTICE: People with coexisting risk factors (low income, low perceived health) are the ones who may benefit most from health-oriented interventions.     

Who Cares for the Caregiver?

Forty-six demented elderly and their caregivers previously studied with respect to strain on caregivers; were studied one year after the initial assessment with respect to institutionalization. Patients admitted to a nursing home, showed more pronounced mental and behavioural disturbances. Cognitive functions, gender, marital status and living conditions did not differ between the two groups. The caregivers of institutionalized demented were older, they expressed more feelings of anger and despair and more often requested the care receiver transferred to a nursing home.     

The relationship between caregiver burden, caregivers' perceived health and their sense of coherence in caring for elders with dementia

Aim. The aim of this study is to examine associations between caregiver burden, perceived health and sense of coherence in family caregivers to persons with dementia living at home. Background. Most of the studies on family caregivers have focused on burden and morbidity. However, the caregiver's sense of coherence and perceived health have not been studied earlier in relation to caregiver burden. Design. A cross‐sectional investigation design was used. Methods. Older persons, 2238 subjects, with any form of social services, were invited to an assessment of cognitive capacity. Those who had cognitive decline (255) were invited for a medical examination and 130 persons were diagnosed as having dementia. The family caregivers to persons with dementia answered a questionnaire including a caregiver burden scale, the Nottingham health profile scale, sense of coherence scale and the Euroqol instrument. Results. The family caregivers experienced moderate burden, and strong associations were noted between burden, especially isolation, disappointment and emotional involvement with perceived health and sense of coherence, adjusted for age and relationship. Caregivers with lower burden reported significantly better perceived health and higher mean score of sense of coherence than caregivers with higher burden. Conclusions. Assessment of status of family caregivers of persons with dementia living at home seems to be gaining considerable importance. The caregiver burden scale and the sense of coherence scale seem to be highly useful for identifying carers at risk of stress, pattern of burden and coping strategies. Relevance to clinical practice. Nurses can help family caregivers to identify their negative experiences about caregiving and can help them reflect upon their coping strategies to find balance in their situation. Risk groups of caregivers may be identified, especially those with low perceived health and sense of coherence, for early interventions to reduce burden.     

Informal family caregiving to older people with dementia: research priorities for community psychiatric nursing

The paper reviews the literature relating to the provision of community psychiatric nursing to demented elderly people and their informal family caregivers, and develops priorities for research in that particular area of nursing Initially, the development of community psychiatric nursing with elderly demented people is examined Various theoretical models articulating the family's experience of dementia are examined as a basis for identifying various priorities for research in the area Empirical evidence relating to the efficacy of various interventions is briefly discussed Various priorities are made regarding the development of research relating to the development of community psychiatric nursing with elderly demented people and their informal caregivers Finally the paper is placed in the context of the present policy of refocusing psychiatric nursing on to people with serious and enduring mental disorders It is argued that this policy should include elderly demented people not just younger people with functional mental disorders     

Vulnerability of family caregivers in terminal palliative care at home; balancing between burden and capacity

This paper reports on a grounded theory interview-based study with 13 family members aged 28-80 years caring for terminally ill people at home (with a life expectancy of 3 months or less) in the Netherlands. The project was approved by the ethics committee of the Maastricht University Hospital. The aim of this study was to explore the experiences of family caregivers, their needs for home care, and which health services they receive. Data were analysed using the constant comparative method. 'Vulnerability' was identified as the core category. Caring for a terminally ill person at home requires continuous balancing between care burden and capacity to cope. Whether or not the carer will succeed in keeping in optimum balance is dependent on a number of factors impinging on the caregiver's vulnerability. Care burden, restricted activities, fear, insecurity, loneliness, facing death, lack of emotional, practical and information-related support were identified from the data as factors having the potential to increase the caregiver's vulnerability, and may be risk factors for fatigue and burnout. Continuing previous activities, hope, keeping control, satisfaction and good support are factors which may decrease the caregiver's vulnerability, and may protect against fatigue and burnout. The experiences of the caregivers in our study showed that the support from informal and professional caregivers was not sufficient. Education and practical tools may make professionals more sensitive for the vulnerable position of family caregivers, even when these caregivers do not show their vulnerability.     

Aggressive behaviour and burnout among staff of homes for the elderly

This study examines relationships between experienced aggressive behaviour and burnout of staff caring for residents living in homes for the elderly (n = 551). Burnout was conceptualized as a three-dimensional syndrome consisting of emotional exhaustion, depersonalization and reduced personal accomplishment. From the results of the hierarchical regression analyses it appeared that physical and psychological aggression and the number of weekly working hours had a significant relationship with emotional exhaustion of staff. Psychological aggression was found to have a significant relationship with depersonalization. Neither sex nor age had a relationship with any of the burnout dimensions. Implications for research and suggestions for work and training of staff caring for the elderly are discussed.     

老年性痴呆患者亲属照料负担与心理健康的相关性分析

目的；了解老年性痴呆患者家庭照料者的照料负担和心理健康状况，提高患者的家庭照料质量和延缓疾病进程，为社区心理卫生服务提供目标依据。方法；采用自编一般情况问卷表、照料负担量表（BCS）、照料者生活变化问卷及90项症状清单量表（SCL-90）对275例老年性痴呆患者的家庭照料者进行问卷调查。结果：共216位照料者接受调查。BCS及照料者生活变化问卷测评显示，老年性痴呆患者的照料负担依次为经济负担〉心理健康〉家庭生活〉家庭关系〉躯体健康〉家庭活动。SCL-90测评显示照料者心理健康水平均有不同程度下降，且照料负担与SCL-90总分呈正相关性，提示家庭照料负担越重，对照料者心理健康影响越大。结论；医生应帮助照料者认识该病，了解照料技巧，适应生存环境及改善其负性心理；同时加强对社区内老年性痴呆疾病的健康宣教，提高收治率，以解决照料者的后顾之忧。     

老年慢性病病人照顾者的负担及其影响因素

[目的]了解老年慢性病病人照顾者的照顾负担现状,分析照顾者负担的影响因素。[方法]以老年慢性病病人及其照顾者的一般资料调查表、照顾者负担量表为研究工具,采用方便抽样法对212例老年慢性病病人照顾者进行问卷调查。[结果]老年慢性病病人主要照顾者的负担总分为（34.55±17.78）分;影响照顾者负担的因素有照顾者与病人的关系、病人年龄、病人病程、家庭经济状况。[结论]老年慢性病病人照顾者存在不同程度的照顾负担,社会应重视老年慢性病病人照顾者的负担,并采取积极有效的应对措施。     

社区生活自理障碍老年人照顾者负担及其影响因素的调查

目的调查社区生活自理障碍老年人照顾者负担水平,探讨影响照顾者负担的相关因素。方法采用非实验性描述性研究,采用日常生活能力量表（ADL）、照顾者人口学资料调查问卷、照顾者负担量表（CBI）调查北京市2个社区72名生活自理障碍老年人及主要照顾者,并进行统计分析。结果72名照顾者轻度负担18名,中度负担50名,重度负担4名。女性照顾者负担大于男性照顾者,有配偶的照顾者比无配偶的照顾者的负担大,不在职照顾者的负担比在职照顾者负担大,自觉身体健康差的照顾者较自觉身体健康好的照顾者的负担大,差异均有统计学意义（P〈0．01或P〈0．05）;生活自理障碍的男性患者照顾者比女性患者照顾者负担大（P〈0．01）,患者ADL得分越高,照顾者的负担越大（P〈0．01）。结论生活自理障碍老年人的照顾者普遍存在不同程度的照顾负担,其总体负担水平处于中度;生活自理障碍老年人照顾者的负担受照顾者的性别、照顾者的婚姻状况、照顾者的自觉身体健康状况、照顾者职业状况、照顾对象的性别及其日常生活能力等因素的影响。     

回族老年2型糖尿病患者主要照顾者照顾感受的质性研究

目的 了解回族老年2型糖尿病患者主要照顾者的照顾感受,旨在为制订符合回族文化特征的老年2型糖尿病患者护理方案提供借鉴。 方法 采用半结构深度访谈法,对15名回族老年2型糖尿病患者主要照顾者进行访谈。 结果 提炼4个主题：爱的体验、老年及女性照顾者负担较重、回族文化及生活习俗对疾病的影响、对社会支持系统的感恩与期望。4个主题中包括8个亚主题。夫妻的角度：感恩,照顾是一场修行;儿女的角度：反哺,爱的回馈;老年照顾者忽略自己的健康;女性付出较多;悲伤不是主旋律;习俗与健康的冲突;感恩国家,看病负担较轻;糖尿病知晓率低,希望获取专业的照顾支持。 结论 回族老年2型糖尿病患者主要照顾者负担感受较轻,老年和女性照顾者负担较重,照顾感受和照顾行为受到回族文化和生活习俗的影响;主要照顾者疾病相关知识缺乏、传统文化与健康饮食有冲突,希望得到符合其文化特征的护理支持。     

Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care: comparisons between a ward for severely demented patients and a similar control ward

The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses ( n = 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward ( n = 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support     

Burnout syndrome among critical care healthcare workers

PURPOSE OF REVIEW: Burnout syndrome is a psychological state resulting from prolonged exposure to job stressors. Because ICUs are characterized by a high level of work-related stress, a factor known to increase the risk of burnout syndrome, we sought to review the available literature on burnout syndrome in ICU healthcare workers. RECENT FINDINGS: Based on most recent studies, severe burnout syndrome (as measured using the Maslach Burnout Inventory) is present in about 50% of critical care physicians and in one third of critical care nurses. Strikingly, determinants of burnout syndrome are different in the two groups of caregivers. Namely, intensivists who have severe burnout syndrome are those with a high number of working hours (number of night shifts and time from last vacation) but determinants of severe burnout syndrome in ICU-nurses are related to ICU organization and end-of-life-related characteristics. ICU conflicts, however, were independent predictors of severe burnout syndrome in both groups. SUMMARY: Recent studies reported high levels of severe burnout syndrome in ICU healthcare workers and identified potential targets for preventive strategies such as ICU working groups, communication strategies during end-of-life care and prevention and management of ICU conflicts.     

老年痴呆患者家庭焦虑照顾者体验的质性研究

目的深入了解老年痴呆患者焦虑照顾者的感受及需求。方法对10名老年痴呆患者的焦虑照顾者进行深度访谈,并运用Claizzi分析程序分析。结果老年痴呆患者焦虑照顾者的体验集中于5个方面:濒临崩溃、缺乏私人时间、经济负担过重、担心、恐惧和不安。结论在研究和关注老年痴呆问题时,不应忽视照顾者所承受的负担及相关问题,家庭、医院和社区建成社会支持网络,提供有效支持方式,给予痴呆照顾者及时的帮助,以提高其心理健康水平。