Zarit burden interview among caregivers of community-dwelling older adults in a caribbean setting (Jamaica): Reliability and factor structure

The Zarit Burden Interview has been the most popularly used tool for measuring caregiver burden and with the 60 years and over population in Jamaica and developing countries expected to increase, caregiver burden and its assessment assume increased importance. Establishing the reliability and underlying factor structure of instruments such as the ZBI is critical. This study sought to determine the reliability of the Zarit Burden Interview and to assess its underlying factor structure. The ZBI was administered to 180 caregivers of community dwelling older persons in Jamaica in a nationally representative sample across four geographic health regions in 2016. The factor structure was identified using exploratory factor analysis (EFA) with Varimax rotation. Cronbach's alpha was used to assess internal consistency/reliability of the instrument. The internal consistency/reliability of the ZBI instrument was high (Cronbach's α = 0.859) and the corrected item-total correlations ranged from 0.134 to 0.730. The ZBI mean score was found to be 16.92 ± 12.04. EFA produced a six-factor model comprised of 19 items which explained 48.97% of total variance, and was subsequently reduced to four (37.27% of total variance) via the use of parallel analysis and scrutiny of confidence intervals. The four factors identified were ‘personal strain’, ‘social relations disruption’, ‘resource strain/imbalance’ and ‘role intensity’. The ZBI-22 tool is a reliable instrument for evaluating caregiver burden among community dwelling older persons in Jamaica. A four factor model has emerged providing greater insights on the underlying constructs of the ZBI, the most widely used caregiver burden assessment tool.     

Participation in Social Activities and the Association with Socio-Demographic and Health-Related Factors among Community-Dwelling Older Adults in Jamaica

Social participation is critical for maintaining independence and facilitating active ageing. The aim of this paper is to describe participation in social activities among older adults in Jamaica and to identify independently associated socio-demographic and health characteristics. We analysed data from a nationally representative, community-based survey of 2943 persons 60 years and older. Sixty-three percent of older adults attended religious services and 60 % were visited by friends at least once per month in the 12 months preceding the survey. Age was not independently associated with social participation. Persons with post-secondary level education were twice as likely as those with primary education or less, to be visited by friends and to attend meetings of formal organisations. Men, persons not in union, and those with less functional independence had reduced odds of attending meetings of formal organisations. These variables were however not independently associated with having visits with friends. Persons with a positive depression screen were between 42 % and 44 % less likely to be visited by friends. Persons who received an income through livestock/farming were more likely to visit or be visited by friends. The variables independently associated with social participation vary depending on the type of social activity considered. Where possible, health and social interventions should focus on prevention, delay and reversal of risk factors associated with reduced social participation. Social participation programmes should be prioritized and be informed by input from older adults. Future research should include other forms of social interactions and clarify older adults’ perceptions of their quality.     

Ageing in place: Implications of morbidity patterns among older persons – findings from a cross‐sectional study in a developing country (Jamaica)

Aim: This paper describes morbidity patterns among older people, relevant health‐care resources in a localised population in a developing country (Jamaica) and implications for ageing in place in the community. Methods: Local morbidity patterns among older people were determined in Jamaica from a 2007 cross‐sectional study involving record searches at major hospitals and clinics. Age‐specific morbidity distributions were compiled. Data on health‐care staff complement were also collected. Results: Non‐communicable diseases predominate in older people in Jamaica; 50% of diagnoses related to cardiovascular disorders and diabetes. Staff‐to‐population ratios were low compared with other international data. Conclusion: A high prevalence of non‐communicable disease coupled with inadequate staffing threatens the likelihood of ageing in place in the Jamaican community. Secondary prevention efforts and social support services which enhance ageing in place are needed.     

Ageing of Jamaica's Population – What Are the Implications for Healthcare?

The 2011 Census has confirmed the ageing of the Jamaican population. The over 60-year old population has increased while the under 15-year old population has decreased. Other demographic changes of note include the largest increase being in the old-old who are predominantly female. The demographic changes when considered with the increase in chronic disease indicate the need for consideration of healthcare specifically targeting the needs for older persons including increased prevention, continuous medical management, long term care and caregiver support.     

Hurricane preparedness among healthcare workers in St James

OBJECTIVE: To assess the preparedness of health workers in St James, Jamaica, to respond to natural disasters. METHODS: A cross-sectional survey was conducted on a 25% quota sample of hospital and health department staff in St James in 2005 (n = 307). Awareness of and attitudes to disaster management policies, plans and training and how these influenced their response in Hurricane Ivan were evaluated Statistical package for the Social Science 11.5 was used to summarize quantitative data, while qualitative data were analyzed manually. RESULTS: Most respondents (67%) knew of the disaster plan but only 40% had been trained in disaster management. More nurses (68%) and paramedicals (51%) reported being trained than ancillary/ auxilliary (33%), medical (21%) or administrative/clerical (18%) staff Most (96%) had participated in at least one disaster preparedness drill, usually a fire drill, but not in the previous two years. Attitudes towards disaster management were positive (99% insisted training should be compulsory, 95% agreed they should help in a hurricane). The majority (86%) reported being available to work at any time and 77% had worked as scheduled during Hurricane Ivan. Transportation and personal responsibility (to children, elderly or property) were the main limiting factors. Provisions for staff welfare (eg transportation, protective gear, media updates) were perceived as inadequate. Having defined disaster response roles was positively correlated with age, years of service and occupation (p < 0.01) CONCLUSION: Health workers in St James have positive attitudes to disaster management but require routine training to compensate for staff turnover. More attention must be given to staff welfare during disasters.     

Chronic disease and ageing in the Caribbean: opportunities knock at the door

Amidst rapid population ageing, the incidence and prevalence of chronic diseases and their sequelae demand reflective and critical looks at the issue and the subsequent development of informed age-sensitive responses. This paper reviews the burden of chronic diseases in the Caribbean, and its relationship to ageing and the demographic transition. Inter-linkages between the social determinants of health, poverty, ageing, and chronic disease are illustrated. Suggestions are made regarding directions to be pursued and the emerging initiative regarding chronic non-communicable diseases being spearheaded at the United Nations by CARICOM countries