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The childcare system in Lithuania is going through extensive changes in order to ensure the preparation and assessment of people who want to care for or adopt a child, on-call guardians have appeared, care centres have started operating in all municipalities, a unified agreement of guardians (carers), on-call guardians, adoptive parents and community children has been approved, as has the GIMK training and counselling programme for nursing home workers. Individuals who want to become a child’s guardian are trained and evaluated, and mutual support groups have started being organised. This is one of the measures aimed at strengthening, supporting and providing assistance to guardians (care givers), and there is an opportunity to solve issues relating to child custody. There are more and more guardians (care givers) who face difficulties in communicating with the ward, their relationship is strained, and the child experiences learning and adaptation difficulties, as a result of which the guardianship process is becoming more and more complicated. The current problem is manifestations of non-constructive behaviour that arise in adolescence, which worsen if these problems are not solved. A frequent guardian (carer) turns to care centre specialists, social workers and psychologists for help. Children’s guardians (carers) need constant qualified assistance from specialists and the state, because only in this way can guardians properly and competently perform their duty and meet the child’s needs and interests. This article analyses the experience of a mutual support group for care givers, and presents a qualitative study. The results of the study confirm the effectiveness of this type of support, and allow us to predict and design other support measures for care givers. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundIntermediate care is often defined as healthcare occurring somewhere between traditional primary (community) and secondary (hospital) care settings. High quality intermediate care is important in dementia, may prevent caregiver burnout and also lead to optimal care for people with dementia. However, very little is known about the point of intermediate care for persons with dementia in Europe.Research questionsWhat intermediate care services exist and how are they utilized in the care of people with dementia in Europe?ObjectiveThis study aims at describing the point of view of General Practitioners on intermediate care services for people with dementia across Europe.MethodsKey informant survey was sent to GPs via a self-developed questionnaire with space for open ended comments. 16 European countries participated to this cross-sectional mixed method study. Given the volunteer nature of the study, no minimum sample size requirements were applied to participation. Convenience sampling technique was used to address variations due to regional variations and regulations within the same country. Descriptive analyses of all intermediate care facilities groups by countries were performed. Qualitative analyses approach was used for the optional-free text to exemplify and/or complete the reasons contained in the closed response categories.ResultsThe questionnaire was sent to 16 European countries. 583 questionnaires were analyzed. The responding physicians were 48 (± 11) years old on average and they had been in practice for an average of 18 (+ /11) years. The types of intermediate care considered were integrated at-home services, respite and relief services, day care centers and nursing homes. Their availability was considered very inhomogeneous by the majority of respondents. The main benefits of intermediate care cited were better medical care for the patient (78%), better quality of life for the caregiver (67%), prevention of the caregiver burden (73%) and a break for the caregiver (59%). The reported difficulties were: accessing these facilities due to limited financial support (76%) and cumbersome administrative procedures (67%). Many other facets of our findings were captured in the qualitative themes that emerged.ConclusionIntermediate care in Europe is diverse and heterogeneous. Major concerns of GPs are about the cost issues and the cumbersome administrative procedures to access them.

Aim: Palliative patients and caregivers of a large living space of their time are affected from many aspects including physical, psychological, social, material and spiritual. This study is a researcher-cross-sectional study of caregiver care burden and factors for palliative patients. Methods: This study was conducted with 98 caregivers who provided care for at least one month to patients hospitalized in the palliative ward of Pursaklar State Hospital between November 01, 2018 and June 15, 2019. "Sociodemographic Data Form" and "Caregiver Stress Scale (BVSÖ)" were used for data collection. In evaluating the data; Percentages, means, One Way Anova, Independent Sample t Test and Mann Whitney U test were used. For statistical significance level p

Introduction: Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome. Materials and Methods: The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS).Results: A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%. Conclusion: The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit

Abstract Background Thailand is a rapidly aging society, which places high demand on home health care services for the elderly. The shortage of health care workforce in rural areas is a crucial obstacle to the delivery of adequate home health care services. The appropriate skill-mix between multidisciplinary health team and care givers (CGs) is an attractive solution for improving home health care services in rural Thailand. This study assessed the potential of trained CGs to provide home health care services and projected what the optimal mix for a multidisciplinary home health care team in rural Thailand would be in 2030. Methods Eleven pilot districts in Thailand were recruited for the study. Secondary data were collected along with surveys of home health care providers. A total of 130 care managers (nurses) and 351 care givers (CG) were recruited for the survey. Workload, skill-mix potential, and acceptance of care givers were assessed in the surveys. The results from secondary data and the survey were used to project the health workforce requirements in 2030. Results It is projected that in 2030 the number of elderly living in rural areas will be 7,156,700 (27% of the projected rural population). Of this, 20.3% will be home-bound, 1.1% will be bed-ridden and 1.6% will need rehabilitation. The main members of the multidisciplinary health workforce involved in home health care were nurses, doctors, and physiotherapists. The home health care services that were provided by the multidisciplinary health workforce included patient assessment, development of a care plan and case conference, home visits, and teaching and supervision of CGs. The CGs were village health volunteers trained to carry out regular home visits to patients. The CGs provided assistance with the activities of daily living, basic health services, moral support to patients and relatives, and surveillance of the home environment during home visits. CGs were well accepted by both the health professionals and the patients. Projections showed that 16,094 nurses, 1,542 doctors, 1,022 physiotherapists and 50,148 CGs will be required in 2030 to meet the needs of the dependent elderly for home health care in rural Thailand. Conclusion With the increased need for home health care services in the future, appropriate team work between the members of the multidisciplinary health team and the CGs in the community is the appropriate solution for likely shortages of health professional workforce.

Aim: Children with a visually impairment often face various challenges in their day-to-day skills. Oral hygiene maintenance is one major task for them. Such child has difficulty to live current normal life and demands of permission or healthy life. The present study aims to assess the oral health in children with visually impaired using oral health status assessment tool in Patna city. Methodology: A cross-sectional institutional survey was implicated among visually impaired children who attend special school in Patna city. A total of 180 visually impaired children were selected as per the inclusion criteria. Participant's parents gave written consent for the study. The oral hygiene practices of visually impaired children were recorded by teachers. Oral health assessment tool (OHAT) findings were recorded by the principal investigator. Results: Sixty-seven percent of children had gingival inflammation and 59.8% had normal tongue. 55.2% of children had 1–3 decayed or broken teeth and 16.1% had unhealthy natural teeth. 78.7% of children had change in oral hygiene. Conclusion: Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool(OHAT). The sentence should be chaged as Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool (OHAT).

Aim: Children with a visually impairment often face various challenges in their day-to-day skills. Oral hygiene maintenance is one major task for them. Such child has difficulty to live current normal life and demands of permission or healthy life. The present study aims to assess the oral health in children with visually impaired using oral health status assessment tool in Patna city. Methodology: A cross-sectional institutional survey was implicated among visually impaired children who attend special school in Patna city. A total of 180 visually impaired children were selected as per the inclusion criteria. Participant's parents gave written consent for the study. The oral hygiene practices of visually impaired children were recorded by teachers. Oral health assessment tool (OHAT) findings were recorded by the principal investigator. Results: Sixty-seven percent of children had gingival inflammation and 59.8% had normal tongue. 55.2% of children had 1–3 decayed or broken teeth and 16.1% had unhealthy natural teeth. 78.7% of children had change in oral hygiene. Conclusion: Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool(OHAT). The sentence should be chaged as Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool (OHAT). [ABSTRACT FROM AUTHOR]

Foot care is one of the management for diabetes mellitus that is important to prevent diabetes ulcers. Studies have proven that people with diabetes will have a lower risk of having diabetes ulcer if they have received health education about foot care to prevent diabetes ulcers Thus, health education is considered very important to help people with diabetes preventing foot ulcer. Health care provider including health professionals and health volunteers should provide health education regularly to the patient, however, due to their workload preventing them from providing this intervention to the patient as well as a lack of knowledge about foot care. Based on the initial interview with diabetes program staff, the health education program is not implemented well yet and they need specific training about foot care for nurses, health volunteers and patients. The aim of this study is to see the effect of foot care health training towards nurses and health volunteers ability performing foot care on diabetes. This study used pre-experimental with pre-test and post-test one-group design to 30 respondents (23 health volunteers and 7 nurses from Puskesmas Batua Makassar). The training was given the research team, and after training, there was follow-up training (two times) where the research team accompanied the respondents to provide foot care to the patients which was assessed through a questionnaire. Data were analysed using the paired t-test.This study found there is an improvement in ability in conducting diabetes foot care among the participants the average before treatment(x = 17.93, SD = 1.363) to (x = 19.37, SD = 0.718) after training. This study has proven the effect of training to improve nurses and health volunteers ability in performing foot care on diabetes patient. Thus, it is recommeded that nurses and health volunteers regularly providing health education related to foot care for diabetes patients to prevent foot ulcer such as including it in Prolanis health education program.

This paper exclusively deals with medical encounters. . Structurally and thematically, it manifests itself in five parts. The First part deals with medical encounters as well as essential speech activities which cover (a) frames (certain types of talk) (b) the patient's account and the patient's story or more precisely the patient telling his story and (c) the act of questioning the patient. The Second part revolves round genre and register. The former, in most cases, suggests that the format of medical encounters is conversational. With register; we have a converse reality that restrictively tries to narrow things and give them a certain flavor. The Third part realizes the technicalities of medical encounters (a) the setting of an interview realized by the clinical atmosphere which either impedes or facilitates medical interviews (b) the operative parts of medical encounters which involve elements like (i) beginning an interview (ii) the main part of an interview (iii) asking questions (iv) probing questions (v) picking up cues (vi) demonstrating active listening (vii) verbal and non- verbal facilitation (viii) other points including clarification, relevance and silent periods (ix) summarizing (c) introductory and terminating talk in a medical encounter (d) ending an interview and (e) defense mechanism in a medical interview. The Fourth part of my study projects clinical discourse and interpersonal communication relationships. The Fifth part presents one model of a medical encounter that is evaluated. The model tells us precisely what goes on between the interviewer and the interviewed. The paper ends with a conclusion that sums up the insights gained by the study and that isolates some of the operative perceptive points for our inspection. A questionnaire has been conducted to explore the physicians' and the patients' attitudes, knowledge and emotional aspects. The results with this questionnaire have been analyzed and then confirmed in my conclusion. [ABSTRACT FROM AUTHOR]

Caregivers of patients with severe mental disorders experience a heavy stress burden that can manifest as psychiatric symptoms mimicking posttraumatic stress disorder (PTSD) and can negatively impact interpersonal relationships and work performance. The present study investigated the prevalence of PTSD symptoms, quality of life (QoL), and stress burden in caregivers of patients with severe mental illness. A total of 70 caregivers of severely mentally ill patients and 70 control subjects who were caregivers of patients with a chronic debilitating medical illness (cardiovascular disease) were recruited from university hospital outpatient facilities. Severe mental illness was defined based on a Global Assessment of Functioning score 2 years. Both groups were evaluated with the Zarit Burden interview, a QoL questionnaire, and Posttraumatic Diagnostic Scale (PDS). The results showed that 37.14% (n = 26) of caregivers of patients with severe mental illness showed PTS symptoms compared to 0% of caregivers of patients with physical illness, and 15.17% (n = 11) met the diagnostic criteria for PTSD. Caregivers of patients with severe mental illness had higher stress burden and lower QoL scores than the control group (p < 0.05). These results indicate that caregivers of patients with severe mental illness have a high stress burden that may lead to PTSD, highlighting the importance of providing psychological support to this group.

Introduction Care givers of patients with severe mental disorders have been shown to be under heavy stress burden that reflect itself through various heterogenous psychiatric symptoms that may mimic PTSD with associated negative impact on interpersonal relations and work performance Objectives to assess the prevalence of PTSD symptoms among care givers of patients with severe mental illness Methods 70 patients care givers of sevely mentally ill patients compred to control 70 care giver of patients with chronic debilitating medical illness were recruited from outpatient of the university hospital outpatient facilities, random selection. Severe mental illness was defined by Global assessment of function GAF score above 50 and duration exceeding 2 years. Both groups were subject to Zarit burden interview to assess stress burden and post traumatic stress diagnostic scale PDS to assess PTSD symptomats Results 43% of care givers of severly mentally patients showed moderate to severe burden on the Zarit scale compared to only 10% among care givers of medically ill patients, this difference was statistically significant (p

Introduction: Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome. Materials and Methods: The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS).Results: A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%. Conclusion: The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit [ABSTRACT FROM AUTHOR]

Caregivers of patients with severe mental disorders experience a heavy stress burden that can manifest as psychiatric symptoms mimicking posttraumatic stress disorder (PTSD) and can negatively impact interpersonal relationships and work performance. The present study investigated the prevalence of PTSD symptoms, quality of life (QoL), and stress burden in caregivers of patients with severe mental illness. A total of 70 caregivers of severely mentally ill patients and 70 control subjects who were caregivers of patients with a chronic debilitating medical illness (cardiovascular disease) were recruited from university hospital outpatient facilities. Severe mental illness was defined based on a Global Assessment of Functioning score <50 and duration of illness >2 years. Both groups were evaluated with the Zarit Burden interview, a QoL questionnaire, and Posttraumatic Diagnostic Scale (PDS). The results showed that 37.14% (n = 26) of caregivers of patients with severe mental illness showed PTS symptoms compared to 0% of caregivers of patients with physical illness, and 15.17% (n = 11) met the diagnostic criteria for PTSD. Caregivers of patients with severe mental illness had higher stress burden and lower QoL scores than the control group (p < 0.05). These results indicate that caregivers of patients with severe mental illness have a high stress burden that may lead to PTSD, highlighting the importance of providing psychological support to this group. [ABSTRACT FROM AUTHOR]

Background: There are many National Health Insurance (NHI) participants who do not yet understand the mechanism of NHI services, including clients who are hospitalized. The phenomena that exist on the field, that the client will enlist the help of health professionals who are always in the ward, especially nurses, to provide information on all matters, including NHI. On the other hand, nurses have a major role in caring for clients, based on their duties and functions. Purpose : This study aims to determine if there is expansion of the role of nurses as care giver and advokator in the inpatient unit, era NHI program. Methods : This research is a descriptive study of the role of nurses as care giver and advokator in inpatient era NHI program, employing triangulation method. Respondents were 64 inpatient clients registered as NHI participants in the Hospital Semarang assigned by proportional simple random sampling, and four nurses. Result : The results showed that there are expanding the role of nurses as care giver and advocator in the inpatient unit, era NHI program. Conclusion : With the implementation of NHI program, the roles of nurses as care giver and advokator has expanded in the inpatient unit. BPJS/NHI parties need to disseminate information relating to NHI to nurses, as well as the need to be given compensatory reward for nurses

Background: Thailand is a rapidly aging society, which places high demand on home health care services for the elderly. The shortage of health care workforce in rural areas is a crucial obstacle to the delivery of adequate home health care services. The appropriate skill-mix between multidisciplinary health team and care givers (CGs) is an attractive solution for improving home health care services in rural Thailand. This study assessed the potential of trained CGs to provide home health care services and projected what the optimal mix for a multidisciplinary home health care team in rural Thailand would be in 2030.Methods: Eleven pilot districts in Thailand were recruited for the study. Secondary data were collected along with surveys of home health care providers. A total of 130 care managers (nurses) and 351 care givers (CG) were recruited for the survey. Workload, skill-mix potential, and acceptance of care givers were assessed in the surveys. The results from secondary data and the survey were used to project the health workforce requirements in 2030.Results: It is projected that in 2030 the number of elderly living in rural areas will be 7,156,700 (27% of the projected rural population). Of this, 20.3% will be home-bound, 1.1% will be bed-ridden and 1.6% will need rehabilitation. The main members of the multidisciplinary health workforce involved in home health care were nurses, doctors, and physiotherapists. The home health care services that were provided by the multidisciplinary health workforce included patient assessment, development of a care plan and case conference, home visits, and teaching and supervision of CGs. The CGs were village health volunteers trained to carry out regular home visits to patients. The CGs provided assistance with the activities of daily living, basic health services, moral support to patients and relatives, and surveillance of the home environment during home visits. CGs were well accepted by both the health professionals and the patients. Projections showed that 16,094 nurses, 1,542 doctors, 1,022 physiotherapists and 50,148 CGs will be required in 2030 to meet the needs of the dependent elderly for home health care in rural Thailand.Conclusion: With the increased need for home health care services in the future, appropriate team work between the members of the multidisciplinary health team and the CGs in the community is the appropriate solution for likely shortages of health professional workforce. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Anatolia Nursing & Health Sciences / Anadolu Hemsirelik Ve Saglik Bilimleri Dergisi is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The number of older people is increasing throughout the world. As individuals grow older, they are faced with numerous physical, psychological and social role changes that challenge their sense of self and capacity to live happily. There are several problems that are likely to make these golden sections of the population depressed and lonely leading to impaired quality of life among elderly persons especially if there seems to be a withdrawal of conventional sources of love, care and respect from the family and near ones. But with the right and timely Professional help of the Geriatric social workers the same phase can be altered for the dignified life, of the old people; to change into an opportunity for making new friends, developing new interests, discovering fresh ways of services, spending more time in fellowship with God to cheer up the golden age, to say that 'the life that ends well is the best end. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to understand the barriers that a particularly vulnerable sub-population of older adults experience in adhering to cancer treatments in rural eastern North Carolina. Qualitative descriptive interviews were completed with 16 individuals (8 cancer patients and their caregivers) about the challenges they face in adhering to cancer treatments. Three themes emerged based on the analysis which included transportation and financial barriers, and assistance that facilitated patients to adhere to treatment protocols. Transportation barriers were those associated with both the formal and informal systems. Financial barriers were related to costs associated with treatment. Participants also reported on ways in which adherence was facilitated via both formal and informal means. Our findings support those of previous research on treatment adherence and add information on the actions patients take in response to barriers that can negatively impact their disease trajectory. The knowledge gained can inform service providers about the issues in treatment adherence and help identify interventions that could support caregivers and patients to circumvent such challenges. [ABSTRACT FROM AUTHOR]

Introduction Interactions with caregivers of patients with severe mental illness like schizophrenia and bipolar affective disorder have revealed negative feelings about the disability status of their relative and burden related to caring for their relative with mental illness. Many caregivers have expressed that the patient‘s disability status affects the family pattern, roles of family members, prosperity of the family and relationship among the family members. Patient outcome and compliance with treatment are also dependent on optimal care giving and addressing family‘s needs. Unfortunately these needs are not routinely considered, addressed or met. Addressing the burden perceived by caregiver and improving their coping can assist with good clinical care of patients with severe mental illness and hence these study to assess the burden perceived by caregiver and their coping. Objectives: To assess the levels of Burden among care givers of patients with affective disorders and To assess the coping strategies among the caregivers of patients with affective disorders. Materials and Method: The researcher used quantitative research approach to assess burden and coping strategies. The research design was descriptive research design. The tool reliability coefficient ‘r’ of the scale was 0.7, hence it was found reliable. Total 120 samples were selected by non Probability convenient sampling technique. Total two scale namely Zarit burden interview and Rating scale for assessing coping strategies to collect data. The conceptual framework adopted is Sr.Calista Roy’s adaptation model (1984) the main concept of this conceptual framework is human being, stimuli, adaptation models and nursing. Results and Conclusion: In this study found the level burden among the care givers of affective disorders patients have experienced 60(50%)were had moderate to severe level of burden, 29(24.17%) were had severe burden, 13(10.83) were had no or little burden and 18(15%) were had mild to moderate burden and levels of coping strategies among care givers, 19(15.83%) were had moderately adequate coping strategies, 93(77.50%) were had adequate coping strategies and 08(6.67%) were had inadequate coping strategies. [ABSTRACT FROM AUTHOR]

Assessment of an individual's functional status, as measured by activities of daily living (ADL), is an essential element in the diagnosis of HIV-associated neurocognitive disorders (HAND) but individuals with cognitive impairment may not accurately report ADL. We assessed agreement between self- and caregiver-reported ADL in HIV-positive persons. Antiretroviral therapy (ART)-naïve HIV-positive persons (n = 321) and HIV-negative controls (n = 134) in Rakai, Uganda, completed neurocognitive tests and an ADL questionnaire. Co-resident relatives ("caregivers") were independently administered the ADL questionnaire to determine their perception of the participant's ADL. The relationship between neurocognitive impairment and participant-caregiver agreement was assessed using kappa statistics. Regression was used to estimate adjusted prevalence ratios (AdjPR) of participant-caregiver agreement on disability scores. Relative to HIV-negative adults, HIV-positive participants scoring at least 1 standard deviation (SD) below the norm on 2 or more neurocognitive tests were classified as having mild neurocognitive impairment and those scoring at least 2 SD below the norm on 2 or more neurocognitive tests were classified as having moderate-to-severe. Mean age was 36 years (SD 8.9), and 53% of participants were male. The rate of ADL agreement between participants and caregivers was 77% for HIV-positive and 87% for HIV-negative participants (AdjPR = 0.89, 95% CI 0.81–0.97, p =.01). Among HIV-positive participants, 41% had moderate neurocognitive impairment, 15% had severe neurocognitive impairment, and 44% were normal. For moderate neurocognitive impairment, the rate of ADL agreement was 69% and for severe neurocognitive impairment, it was 66%. Compared to non-impaired HIV-positive participants (86% ADL agreement), ADL agreement was lower with moderate impairment (AdjPR = 0.89, 95%CI 0.81–0.98, p =.023) and severe impairment (AdjPR = 0.77, 95%CI 0.63–0.95, p =.014). Gender, education and CD4 count were not associated with ADL agreement. HIV-positive persons with neurocognitive impairment have lower agreement with caregivers' reports of ADL than HIV-positive persons without cognitive impairment. [ABSTRACT FROM AUTHOR]

The husbands of women undergoing mastectomy have been introduced as the patient’s primary caregivers. This research was conducted to investigate the lived experiences of Iranian Muslim husbands of women undergoing mastectomy. In this phenomenological research, 18 participants were interviewed, and Van Menan’s method of interpretation was used to interpret the data. 8 themes were extracted from the data analysis: physical problems, living in the shadow of fear and discomfort, and destiny is not blameless, modified roles, marital coldness, imposing a financial burden, spiritual care, and support failure. It is concluded that the husbands of these patients need comprehensive support, and the current support is not enough. [ABSTRACT FROM AUTHOR]

Objective: Progression of amyotrophic lateral sclerosis (ALS) depends on several factors linked to the disease. However, both the patient’s living place and care organization role need to be evaluated. Methods: We analysed the effect on survival of factors linked to ALS or the socio-geographical context in a prospective cohort of 203 patients followed between 2003 and 2011. Results: Patients were 97 females and 106 males with a mean age of 65.5 years. Survival was longer in younger patients, in case of upper limb involvement, longer time to diagnosis, and initially higher forced vital capacity. Non-invasive positive pressure ventilation (NIPPV) and percutaneous gastrostomy (PEG) failed to demonstrate benefit. Patients who lived at home had longer survival. The nature of non-medical organization at home statistically influenced survival, which was longer with an organized network than with an unorganized one and shorter in absence of non-medical organization. In patients with indication of PEG and NIPPV, the proposition was statistically different according to the care givers. Conclusions: Besides the natural history of ALS, survival depended on home organization and the presence or the nature of a home-care system. Home organization was an important factor of decision for NIPPV and PEG proposals. [ABSTRACT FROM AUTHOR]

Introduction Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal care givers. The case manager provides support in addition to the care provided by the home care nurse and general practitioner, potentially leading to more complexities in care coordination. This study describes what informal care givers think about the number of professionals involved in primary palliative care and what support is and is not provided by the general practitioner, the community nurse and the case manager according to the informal care givers. Methods A questionnaire was filled in by the case manager upon referral, and the informal care giver (n = 178) completed a questionnaire two months after the patient had died. Frequencies (the number of professionals) and cross tabs (for support) were calculated. Results The number of healthcare professionals involved was appropriate according to the vast majority (91%) of informal care givers. Support was provided by all three professionals, but a small proportion (14%) of informal care givers did not receive sufficient information on possibilities of care and support from any of the care providers. Discussion Reluctance to involve a case manager is unnecessary, as long as the role of each professional is explained to patients and informal care givers. At all times, support should be offered to the informal care givers as well as to the patient. Added value of the case manager is found in offering specific knowledge of palliative care. [ABSTRACT FROM AUTHOR]

Background: Use of tobacco in cigarettes indeed represents a health concern of growing magnitude among cigarette smokers. As a consequence of its addictive qualities, the consumption of cigarettes often becomes a lifelong habit, with cumulative and deleterious effects on health. Smokeless tobacco has been advocated as a substitute for cigarette smoking. On the contrary, the use of smokeless tobacco is fraught with health risks and needs to be discouraged. Modernisation of life style has affected the population even in rural areas, leading to addiction. Smokeless tobacco is presumed to be less of an evil by the rural folk. Khaini addicts are likely to suffer from mental and physical exhaustion, leading to stress. Khaini is tobacco with slaked lime. This is important in view of the prevailing socio-economic as well as the healthcare system available in any developing country. Therefore, the present study is designed to measure the heart rate variability (HRV) among this special group of the population. Materials and Methods: Fifteen male subjects were enrolled from the rural farm labors′ population who regularly chew khaini. They were free from any type of physical and mental health issues and were non-smokers. A similar group of 15 male subjects anthropometrically matched, who did not chew khaini and did not use tobacco in any form, participated as controls. Each individual volunteer was subjected to an HRV analysis on three occasions: the first record was performed on the first day of their arrival in the hospital as subjects during the lean season. The second observation was recorded after 3 months. The final HRV analysis was performed after 6 months of the first recording. Two types of parameters were analyzed: time domain and frequency domain. Statistical analysis was performed using a paired t-test within the study group and the unpaired t-test between non-khaini chewing controls and subjects on Day 1 of the recording. Results: There was no statistically significant difference between the controls and the study group on Day 1 of recording. Both the HRV parameters - time and frequency domain, showed decreased values during the third month and sixth month recording as compared with the first week recording. The decrease is much more during the sixth month recording as compared with the third month recording. A statistically significant decrease is observed in the mean RR interval, heart rate, very large frequency and large frequency only when the first week recording is compared with the third month recording, but when the first week recording is compared with the sixth month recording, a significant decrease in the mean RR interval and heart rate is found. Conclusion: Subjects involved in taking khaini are likely to undergo a lot of physical and mental stress thus affecting their autonomic status. This adds up to the stress induced by their occupation. HRV analysis using short-term electrocardiogram recordings was used to detect changes consequent with this stress.

Se realizó una intervención educativa desde julio de 2008 hasta enero de 2010 en el Policlínico Docente "Ramón López Peña" de Santiago de Cuba para aplicar una estrategia capacitante sobre cuidados paliativos, dirigida a 24 mujeres encargadas de atender a igual número de familiares con enfermedad terminal. Antes de ser instruidas al efecto, la mayoría de las cuidadoras desconocían cómo controlar los síntomas en sus parientes y su propio estrés, carecían de preparación psicológica para enfrentar el duelo, no habían adquirido las habilidades comunicativas necesarias y muchas se mostraban insatisfechas con el apoyo profesional recibido, entre otros factores; sin embargo, los encuentros programados permitieron brindarles la orientación y el asesoramiento requeridos para asumir con seguridad y confianza el rol que debían desempeñar responsablemente en esa humana labor.An educational intervention was carried out from July, 2008 to January, 2010 at "Ramóm López Peña" Teaching Polyclinic in Santiago de Cuba in order to apply an effective strategy on hospice care so as to train 24 women in charge of attending the same number of terminally ill family members. Before the training, most of female care givers did not know how to control symptoms of their ill relatives, not even their own stress; they had no psychological training to face the challenge; they had not developed the necessary communicative skills; and most of them were not satisfied with the professional aid received; among other factors. However, the scheduled meetings allowed health workers to offer the required orientation and expert advice to these care givers so they could assume their roles with confidence and security taking into account they had to perform a human task with a lot of responsibility.

PERAN KELUARGA SEBAGAI CARE GIVER TERHADAP PENGELOLAAN AKTIFITAS PADA LANSIA DENGAN PENDEKATAN NIC (NURSING INTERVENTION CLASSIFICATION) DAN NOC (NURSING OUTCOME CLASSIFICATION) The Role of The Family As a Care Giver of Management Activity In Elderly With Approach NIC (Nursing Intervention Classification) And NOC (Nursing Outcomes Classification) Dewi Baririet Baroroh1 & Nurul Irafayani2 1&2Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang Jl. Bendungan Sutami no. 188 A Malang ABSTRAK Proses globalisasi berdampak pada berkurangnya peran keluarga, dan hal tersebut dapat mempengaruhi kesejahteraan lansia sebagai bagian dari keluarga. Lansia menjadi kehilangan pertalian keluarga, yang diharapkan dapat memberikan perhatian yang lebih kepada mereka. Sedangkan pada lansia sendiri, karena kemampuan fisik, psikologis, sosial dan mental yang mulai berkurang, menyebabkan berkurangnya peran dan status lansia dalam keluarga. Pada kondisi tersebut lansia butuh bantuan dalam beraktifitas, baik bantuan ringan maupun bantuan yang sifatnya sangat tergantung. Aktifitas yang cukup dan tepat, dapat meningkatkan kulitas hidup lansia. Keluarga sebagai care giver, memiliki peran dalam pengelolaan aktifitas lansia. Lansia dengan kecenderungan pasif dan tidak menikmati kehidupannya akan mudah terserang penyakit. Hal ini, merupakan salah satu peran perawat untuk membina keluarga dan lansia, sehingga kesehatan, kesejahteraan dan kualitas hidup lansia dapat terpenuhi dengan baik. Penelitian ini bertujuan untuk mengetahui peran keluarga sebagai care giver terhadap pengelolaan aktifitas pada lansia. Metode penelitian yang digunakan menggunakan deskriptif analitik dengan pendekatan cross sectional. Sampel penelitian ini adalah 66 keluarga yang memiliki lansia, dengan purposive sampling. Pengumpulan data menggunakan metode wawancara dan observasi. Teknik analisa yang digunakan yaitu Korelasi Spearman Rank (Rho). Hasil analisa data menunjukkan koefisien korelasi hitung sebesar 0,254 dan signifikansi sebesar 0,040. Hal ini menunjukkan bahwa peran keluarga sebagai care giver memberikan pengaruh terhadap pengelolan aktifitas pada lansia. Kata kunci : peran keluarga, care giver, pengelolaan aktifitas, NIC, NOC. ABSTRACT Globalization can influence decreased of value and rule of family due to elderly. The elderly lost their relationship with their family whom gives them attention and care. On the contrary, elderly have physiological, psychological, mentally and social deflated which is attenuating their rule and value to family. Thus, elderly need to be supported by family to rearrange their activity, not only endorsement but also a lot of dependency. Appropriate activity which given or arrange by family as care giver will underpin their quality of life. This point is one of nurse concerns to lead family and elderly to improve healthy, wealthy and quality of elderly life. The objectives of this research is analyze rule of family as care giver toward activity program of elderly. The method of this research used analytic descriptive with cross sectional approach. The sample was 66 families which are choosen by purposive sampling. The data were collected by observation and interview. The data were analyzed by Spearman Rank Correlation (Rho) with significance p< 0,05. The result showed that rule of family in activity therapy had significant correlation to improve quality of elderly life (p=0,040, r=0,254). Keyword : rule of family, care giver, activity program, NIC, NOC.

Background: The spousal care givers of people with Parkinson's (PwP) have unique, first-hand information that is invaluable in the effective management of Parkinson's disease (PD). However, there is a dearth of research that specifically focuses on health professionals’ experiences of engagement with the spousal care givers of PwP.Methods: Interpretative phenomenological analysis (IPA) was used to describe and identify the meaning that health professionals working with PD (HPPs) gave to their engagement experiences with spousal care givers of PwP. Semi-structured interviews with a purposive sample of 12 HPPs were digitally recorded, transcribed verbatim and analysed for emerging themes.Results: Two major themes emerged from the interviews with HPPs: (i) the Philosophy of Care (PoC) is an Intrinsic Element in the Engagement Experience; and (ii) HPPs Expressed a Deep Appreciation of Partners’ Support of the PwP. HPPs experienced significant tensions and challenges in their engagements with the partners of PwP, as a result of the interaction between their lived reality and their PoC. They also appreciated greatly the caregiving provided by the partners. The insights gained have the potential to ease or resolve problematic tensions within the engagement process. [ABSTRACT FROM PUBLISHER]

Aims: This study sought to address two questions: 1) what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX) when completed by patients, their significant others, and clinicians; and 2) does the factor structure of the DEX vary for these three groups?Methods: We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters – significant others (DEX-SO) such as partners and close family members and clinicians (DEX-C), who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient’s level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician). Principal component factor analyses were also conducted for each of the three groups.Results: The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians.Conclusion: Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX.

Purpose: To generate an understanding of the opinions of key people associated with a program for older people transitioning from hospital back to the community and explore their thoughts around training family members to help provide physiotherapy.Method: A qualitative study using focus groups and semi-structured interviews was conducted. Participants included patients admitted to a transitional care program, their family members, physiotherapists working in transitional care and members of a consumer group from the health service where the transitional care program was based. Data were transcribed verbatim and a thematic analysis was conducted.Results: Four patients, four family members, four consumer group members and eight physiotherapists participated in this study. Three themes emerged: family members providing physiotherapy may improve outcomes for patients; training family members to provide physiotherapy should include key elements and be individualised; and involving family members in physiotherapy may impact positively and negatively on people and relationships.Conclusions: Older people transitioning from hospital to the community are at risk of functional decline and may receive very little physiotherapy. Training family members to assist with physiotherapy was perceived as a way to improve patient outcomes and relationships between patients and their family, although there were concerns raised about caregiver stress. Evaluation of the feasibility and effectiveness of this approach is warranted.Implications for RehabilitationOlder people transitioning from hospital to the community are at risk of functional decline and often receive very little physiotherapy.Training family members to assist with simple physiotherapy programs may increase the amount of physiotherapy patients transitioning from hospital to the community can receive and improve functional outcomes for patients.Stakeholders perceive that individualising a program to patient and family member needs is important.Involving family members in physiotherapy may not increase caregiver stress and may improve relationship dynamics between patients and family members. [ABSTRACT FROM AUTHOR]

Termination of parental rights (TPR) is one of the most important decisions made by the legal system. Due to the importance of the TPR legal process, it is essential to understand the risk and protective factors that influence TPR decisions and under which conditions these factors are most influential. This commentary begins with a brief review of the literature regarding TPR. Subsequently, the Ben-David article is reviewed, highlighting the strengths and challenges that emerge from the study. Future directions are then discussed, with a focus on several recent articles that should guide researchers in the TPR field. Finally, clinical implications for social service providers and agencies are explored, with particular attention to how the TPR literature can guide best practices in clinical work. [ABSTRACT FROM AUTHOR]

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Aims: This study sought to address two questions: (1) what is the inter-rater reliability of the Dysexecutive Questionnaire (DEX) when completed by patients, their significant others, and clinicians; and (2) does the factor structure of the DEX vary for these three groups? Methods: We obtained DEX ratings for 113 patients with an acquired brain injury from two brain injury services in the UK and two services in Ireland. We gathered data from two groups of raters--"significant others" (DEX-SO) such as partners and close family members and "clinicians" (DEX-C), who were psychologists or rehabilitation physicians working closely with the patient and who were able to provide an opinion about the patient's level of everyday executive functioning. Intra-class correlation coefficients and their 95% confidence intervals were calculated between each of the three groups (self, significant other, clinician). Principal axis factor (PAF) analyses were also conducted for each of the three groups. Results: The factor analysis revealed a consistent one-factor model for each of the three groups of raters. However, the inter-rater reliability analyses showed a low level of agreement between the self-ratings and the ratings of the two groups of independent raters. We also found low agreement between the significant others and the clinicians. Conclusion: Although there was a consistent finding of a single factor solution for each of the three groups, the low level of agreement between significant others and clinicians raises a question about the reliability of the DEX. [ABSTRACT FROM AUTHOR]

The HIV epidemic has resulted in the death of many people in their reproductive years, leaving behind orphans who are sometimes cared for by their elderly relatives despite the feebleness of their aging bodies. The purpose of the study was to explore and describe the health challenges of elderly people caring for children orphaned by AIDS. This research was conducted as a qualitative phenomenological exploratory, descriptive, and contextual study, conducted in the Mafikeng Municipality of North-West province in South Africa. Data were collected from December 2011 to February 2012 through individual face-to-face interviews and field notes. Elderly people's health challenges in caring for children orphaned by AIDS centred on physical, psycho-emotional, economic and, psychosocial constraints, linked to re-parenting at an old age or because of losing their own children and relatives to AIDS. They experienced physical exhaustion as a challenge of caring for the children orphaned by AIDS as the capacity of their bodies was now reduced and they also had to meet the physical, emotion and spiritual needs of the orphans as well as providing them with food, clothing and shelter. Lack of sleep, dizziness, elevated blood pressure, low glucose levels and asthmatic attacks were also aggravated by contemplating how to fend for these children or owing to the fact that the orphans were very stubborn and took the elderly for granted. This study afforded an understanding of the health challenges elderly people experience in caring for children orphaned by AIDS. The study also recommended some of the interventions that can assist elderly people in this role they play of caring. Based on the findings, it can be deduced that on top of health challenges they face, they are obliged to deal with the added burden of caring for orphaned children by AIDS. [ABSTRACT FROM AUTHOR]

The present study was conducted on 120 elderly respondents of 60 years and above of both the sexes, selected through convenience sampling from two villages of Kendrapara district of Odisha. The findings of the study suggest that till now elderly people prefer to live with their family instead of any institution, as the family members (primarily spouse, daughter-in-law, who are considered as primary care giver) provide all types of support to them and the elderly mainly dependent upon them for their ADL and IADL activities. The findings also suggest that in spite of differences in attitude of two generations, members of family provide care to the elderly people and the relationship between care giver and care receiver is positive till date in rural areas of Odisha. [ABSTRACT FROM AUTHOR]

Aims: The aim of the present study is to assess the level and areas of stress among care givers nursing their loved ones suffering from cancer. Setting and Design: An assessment of care givers' stress providing care to cancer patients at Cipla Palliative Care Center was conducted. The study involves data collection using a questionnaire and subsequent analysis. Materials and Methods: A close-ended questionnaire that had seven sections on different aspects of caregivers' stress was developed and administered to 137 participants and purpose of conducting the survey was explained to their understanding. Caregivers who were willing to participate were asked to read and/or explained the questions and requested to reply as per the scales given. Data was collected in the questionnaires and was quantitatively analyzed. Results: The study results were showed that overall stress level among caregivers is 5.18 ± 0.26 (on a scale of 0-10); of the total, nearly 62% of caregivers were ready to ask for professional help from nurses, medical social workers and counselors to cope up with their stress. Conclusion: Stress among caregivers ultimately affects quality of care that is being provided to the patient. This is also because they are unprepared to provide care, have inadequate knowledge about care giving along with financial burden, physical and emotional stress. Thus interventions are needed to help caregivers to strengthen their confidence in giving care and come out with better quality of care. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To review the published/reported experiences and views of parents’ whose child has had a tracheostomy. To date, no review has focused specifically on parents’ experiences and views of having a child with a tracheostomy. Methods: MEDLINE, CINAHL, PsycINFO and Embase were systematically searched from 1990 to 2012 and a review of reference lists was conducted. The review draws on articles where parents’ views of caring for their child's tracheostomy were either the sole focus of the research or where parental views of caring for their child's tracheostomy have been sought as a subsidiary aim. Studies relating to the aims of the review were examined using quality appraisal tools and in line with criteria for inclusion of studies. Studies were excluded if findings were about adults, studies that only focused on children's or sibling's views were not based on empirical work (e.g. literature reviews or expert commentary) or were not published in the English language. Findings were summarised under thematic headings. Results: The systematic database search identified 442 citations of which 10 were eligible for inclusion in the review. Of those 10 studies six were quantitative and four qualitative. Only one paper published qualitative data specifically on parents’ experiences about their tracheotomised child. The three main themes identified were parents’ experiences of caregiving, their social experiences and experiences of service delivery of having a child with a tracheostomy. Although parents encountered emotional and social challenges, some positive responses to these challenges were reported. Conclusion: This review identifies a lack of qualitative research on parents’ views of having a child with a tracheostomy. Issues surrounding parental management of tracheostomy require further investigation. This review has identified the need to elicit parents’ longitudinal experiences of having a child with a tracheostomy. [Copyright &y& Elsevier]

Background: Stroke is the disease with the highest costs for hospital care and also after discharge. Early supported discharge (ESD) has shown to be efficient and safe and the best results with well-organised discharge teams and patients with less severe strokes. The aim is to investigate if very early supported discharge (VESD) for stroke patients in need for on-going individualised rehabilitation at home is useful for the patient and cost effective. Methods/design: A randomized controlled trial comparing VESD with ordinary discharge. Inclusion criteria: confirmed stroke, >18 years of age, living within 30 min from the stroke unit, on day 2 0-16 points on the National institute of health stroke scale (NIHSS) and 50-100 points on the Barthel Index (BI), with BI 100 then the patient can be included if the Montreal Cognitive Assessment is < 26. Exclusion criteria are: NIHSS >16, BI < 50, life expectancy < 1 year, inability to speak or to communicate in Swedish. The inclusion occurs on day 4 and in block randomization of 20 and with blinded assessor. Primary outcome: levels of anxiety and depression. Secondary outcomes: independence, security, level of function, quality of health, needs of support in activities of daily living and caregiver burden. Power calculation is based on the level of anxiety and with a power of 80%, p-value 0.05 (2 sided test) 44 persons per group are needed. Data is gathered on co-morbidity, re-entry to hospital, mortality and a health economic analysis. Interviews will be accomplished with a strategic sample of 15 patients in the intervention group before discharge, within two weeks after homecoming and 3 months later. Interviews are also planned with 15 relatives in the intervention group 3 months after discharge. Discussion: The ESD studies in the Cochrane review present hospital stays of a length that no longer exist in Sweden. There is not yet, to our knowledge, any study of early supported discharge with present length of hospital stay. Thus it is not clear if home rehabilitation nowadays without risks, is cost effective, or with the same patient usefulness as earlier studies. [ABSTRACT FROM AUTHOR]

Objective: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process. Design: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects. Results: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects. Conclusion: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays. [ABSTRACT FROM AUTHOR]

The social organization of care has many important implications for economic inequality in the U.S. today. In this paper, three dimensions are discussed: 1) Care affects standards of living. Flows of money and time within the family have profound impacts on relative standards of riving. Standard measures of poverty and inequality generally understate the needs of dependents, and therefore overstate the well-being of families caring for children, the elderly, or the sick or disabled. 2) Care affects political alignments. The costs of providing family care represent an increasingly important component of earnings inequality between men and women. Opportunities to »outsource« care services intensify differences based on citizenship, race/ethnicity and class. Yet the growing importance of outsourcing may also foster alliances between producers and consumers who share an interest in maintaining and improving care quality 3) Care inequalities reproduce income inequalities. Differences in the quantity and quality of care that children receive have a significant impact on their future earnings. Women are particularly vulnerable to poverty in old age because they accumulate fewer Social Security and pension credits in the labor market. Growing recognition of these dynamics is generating support for new public policies focusing on investments in human capital that could potentially reduce inequality among children and among caregivers or carers. [ABSTRACT FROM AUTHOR]

Abstract Background Caregivers have a considerable role in caring and recovery of cancer patients. They may experience psychological problems such as depression, anxiety and decreases in quality of life (QOL). Present study aimed to explore depression and quality of life and their relationship among care givers of patients with breast cancer . Methods In this cross sectional study, enrolled 63 care givers of women with breast cancer attending IMKH hospital in Iran as outpatients during 2009–2010. In order to assess the QOL and depression, we used Caregiver QOL Index-Cancer (CQOL-C) and Beck Depression Inventory respectively. Results We found depression has strong negative correlation with QOL and participants with depression were more likely to have a poorer overall QOL. Conclusions Depression has some effects on QOL of breast cancer patients’ care givers. Assistance and giving information through education and intervention from healthcare professionals is the key of improve the ability of caregivers to enhance their QOL.

Introduction: Care givers of patients with severe mental disorders have been shown to be under heavy stress burden that reflect itself through various heterogenous psychiatric symptoms that may mimic PTSD with associated negative impact on interpersonal relations and work performance Objectives: to assess the prevalence of PTSD symptoms among care givers of patients with severe mental illness Methods: 70 patients care givers of sevely mentally ill patients compred to control 70 care giver of patients with chronic debilitating medical illness were recruited from outpatient of the university hospital outpatient facilities, random selection. Severe mental illness was defined by Global assessment of function GAF score above 50 and duration exceeding 2 years. Both groups were subject to Zarit burden interview to assess stress burden and post traumatic stress diagnostic scale PDS to assess PTSD symptomats Results: 43% of care givers of severly mentally patients showed moderate to severe burden on the Zarit scale compared to only 10% among care givers of medically ill patients, this difference was statistically significant (p<0,001). Among care givers of severly mental patients showedmoderate to severe score on post traumatic stress diagnostic scale compared to 0% among those taking care of medically ill patients. this differencewas statistically significant (p<0,001) Conclusions: Stress burden among care givers of patients with severe mental illness is high and may manifest symptoms of post traumatic disorder. This highlight the importance of particular psychological support and assessment among care givers of patients with sever mental illness. [ABSTRACT FROM AUTHOR]