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Background: Supportive care has been found to improve quality of life and reduce the disease burden for aging individuals. After a heart attack, elderly patients often require a caregiver. In developing communities, caregiving responsibilities frequently fall on family members. Accordingly, we designed a randomized controlled clinical trial to assess the effect of an educational program on perceived stress and care burden among family caregivers of elderly heart attack patients. Method: In this clinical trial (IRCT20220905055894N1, 01/02/2023), family member caregivers were the study participants, assigned to either intervention or control groups using a simple random sampling method. The control group received only routine in-home caregiving information, without additional nurse training or support, whereas the intervention group received multimedia-based training, monitoring, and communication support from a trained nurse over one month. Perceived stress levels and caregiving burden were measured using the Perceived Stress Scale (PSS) and the Caregiving Burden Inventory, respectively. Results: Before the intervention, a high level of caregiving stress (34.07 ± 8.61 in the control group vs. 34.17 ± 8.62 in the intervention group) and burden (77.7 ± 15.51 in the control group vs. 79 ± 15.6 in the intervention group) was observed. After one month of intervention, the average scores of stress and burden remained unchanged in the control group, whereas the intervention group showed a significant reduction (P < 0.001). The inter-group comparison revealed lower levels of stress and care burden in the intervention group (P < 0.001). Conclusion: A brief multimedia education intervention could help alleviate the stressful conditions experienced by family caregivers of elderly heart attack patients. Future studies could investigate whether a more extended educational program would have more lasting effects. [ABSTRACT FROM AUTHOR]

Background: Duchenne and Becker muscular dystrophies (DBMD) are rare progressive, X-linked diseases of muscle wasting characterised by the early onset and prognosis of premature death. The aim of this study was to evaluate the impact of providing care for a person with DBMD on caregivers' quality of life, perceived burden and financial well-being. Results: 202 Polish caregivers of a person with DBMD were included and completed a self-administered, computer-assisted online survey. Results show that DBMD affects the quality of life of caregivers who score significantly lower than the national average in every domain: 85.1% of DBMD caregivers scored below the national average in the physical health domain; in the environmental domain 83.7%; in the social relationships domain 82.2%; and in the psychological domain 72.3%. It also demonstrates that DBMD is a source of severe burden (mean score of 35.3). Finally, we report that while some dimensions of respondents' quality of life and perceived burden were associated with patients' age and caregivers' educational status, financial well-being was the most important predictor of respondents' quality of life and caregiving burden. Conclusions: To improve DBMD caregivers' quality of life and alleviate their burden, future intervention programs should promote resiliency and active coping and develop a social support system and respite care. Additionally, it is crucial to provide caregivers with adequate financial resources to fulfil their needs. [ABSTRACT FROM AUTHOR]

Background: Caregiving for people with mental illness (PwMI) could be burdensome, especially for informal caregivers. However, there is a scarcity of research investigating caregiving burden among informal caregivers of PwMI in China at the national level. To fill this gap, this study examined the prevalence of caregiving burden, depression, and anxiety, as well as their associated factors, among a cross-sectional sample of informal caregivers of PwMI in China. Methods: Data were collected via an online survey between June and November 2023. Caregiving burden, depression, and anxiety were measured by the Zarit Burden Interview, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Information on caregivers' sociodemographic, care recipients' sociodemographic and disease-related, and caregiving-related characteristics was also collected. Hierarchical regression analyses were performed to identify associated factors of caregiving burden, depression, and anxiety. Results: A total of 1,224 informal caregivers of PwMI in China were included in the final analysis. 72.1% of the participants had high caregiving burden, 53.5% had moderate to severe depression, and 43.1% had moderate to severe anxiety. Caregiving burden, depression, and anxiety were inter-correlated with each other but exhibited different profiles of associated factors. The most important factors associated with all the three outcomes were disease-related characteristics, particularly care recipients' symptom stability, medication compliance, and insight. Informal caregivers of males with mental illness had higher levels of caregiving burden, depression, and anxiety than those of females. There was a lack of differentiation in caregiving burden, depression, and anxiety based on care recipients' diagnosis. Formal or common-law marriage was a protective factor for caregiver depression and anxiety but not for caregiving burden. Conclusion: Informal caregivers of PwMI in China experienced a high level of caregiving burden, depression, and anxiety. Urgent actions are needed to relieve caregiving burden, depression, and anxiety among informal caregivers of PwMI in China. [ABSTRACT FROM AUTHOR]

Abstract Background Effective response and reducing the burden of family care for children with cancer is critical, and China currently lacks a specific assessment tool. Aims This study aimed to translate and validate the Caregiving Burden Scale for Family Caregivers of Children with Cancer (CBSFC-CC) and then test and implement the tool. Methods According to the Beaton cross-cultural debugging guide, preliminary Chinese version of CBSFC-CC scale was formed, which was suitable for Chinese language environment and clinical context. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were performed to verify structural validity. Convergent validity, discriminant validity and reliability were also conducted. Results A total of 529 family caregivers of children with cancer participated in the survey. EFA extracts and combines four factors and explained 65.80% of the total variation. CFA proved that all the goodness-of-fit indicators were acceptable. The Cronbach’s alpha of the Chinese version of CBSFC-CC was .96, and the test–retest reliability coefficient was .95. Four dimensions and 29 items were identified in the final Chinese version of CBSFC-CC. Conclusion The chinese version CBSFC-CC is scientifically reasonable and has good reliability and validity, which can be applied to the investigation of the nursing burden of family caregivers of children with cancer in China.

Objective: The purpose of this study was to determine the impact of socio-demographic and health characteristics, caregiving stress, life satisfaction, and quality of life on the caregiving burden in caregivers of Alzheimer’s patient. Methods: This study is a descriptive-correlational type study. A total of 146 individuals who are caregivers of Alzheimer’s patient constitute the sampling of the study. The Zarit Burden Interview, Caregiver Strain Index, Satisfaction with Life Scale, and SF-36 Quality of Life. Results: The care burden mean score of caregivers was 61.29±10.3. It was determined that age (β=0.648), caring duration (β=0.429), gender(β=0.672), marital status(β=0.936), educational status(β=0.863), the affinity of the caregiver with the patient(β=0.734), working status(β=0.524), perceived income adequacy(β=0.926), perceived health condition(β=0.682), presence of chronic disease(β=0.529), caregiving stress(β=0.633), life satisfaction score(β=-0.775), physical subscale score (β=-0.824) and mental subscale score(β=-0.489) quality of life had an influence on the caregiving burden (p<0.001). It was determined that the effective determining factors account for 76.4% of the variation in the caregiving burden. Conclusions: The caregivers of Alzheimer’s disease patients have a high caring burden. In addition to the socio-demographic and health characteristics of caregivers, caregiving stress, life satisfaction, and quality of life are important determinants of the caring burden. [ABSTRACT FROM AUTHOR]

Background: Effective response and reducing the burden of family care for children with cancer is critical, and China currently lacks a specific assessment tool. Aims: This study aimed to translate and validate the Caregiving Burden Scale for Family Caregivers of Children with Cancer (CBSFC-CC) and then test and implement the tool. Methods: According to the Beaton cross-cultural debugging guide, preliminary Chinese version of CBSFC-CC scale was formed, which was suitable for Chinese language environment and clinical context. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were performed to verify structural validity. Convergent validity, discriminant validity and reliability were also conducted. Results: A total of 529 family caregivers of children with cancer participated in the survey. EFA extracts and combines four factors and explained 65.80% of the total variation. CFA proved that all the goodness-of-fit indicators were acceptable. The Cronbach's alpha of the Chinese version of CBSFC-CC was.96, and the test–retest reliability coefficient was.95. Four dimensions and 29 items were identified in the final Chinese version of CBSFC-CC. Conclusion: The chinese version CBSFC-CC is scientifically reasonable and has good reliability and validity, which can be applied to the investigation of the nursing burden of family caregivers of children with cancer in China. [ABSTRACT FROM AUTHOR]

Kai-Ming Jhang,1,&ast; Guan-Chun Liao,2,&ast; Wen-Fu Wang,1,&ast; Yu-Chun Tung,3,&ast; Shao-Wei Yen,4 Hsin-Hung Wu2,5 1Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; 2Department of Business Administration, National Changhua University of Education, Changhua, Taiwan; 3Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan; 4Department of Information Management, National Changhua University of Education, Changhua, Taiwan; 5Faculty of Education, State University of Malang, Malang, East Java, Indonesia&ast;These authors contributed equally to this workCorrespondence: Hsin-Hung Wu, Email hhwu@cc.ncue.edu.twPurpose: This study aimed to find the caregiving burden level for patients with dementia who had multiple chronic diseases by simultaneously considering both patient and caregiver factors.Participants and Methods: A cross-sectional study with 284 patients with dementia having multiple chronic diseases managed by the dementia collaborative care team at Changhua Christian Hospital in Taiwan was conducted. The input variables were from patients, such as age, gender, mood symptoms, and behavioral and psychological symptoms, and caregivers, including age, relation to the patient, caregiver’s mood, and caregiving burden. The Apriori algorithm was employed to determine the association between patient and caregiver factors and different caregiving burden levels by setting up the minimum support of 1% and confidence of 90% along with lift > 1.Results: When caring for patients with dementia, twenty scenarios were found for caregivers with a severe burden. In addition, 1936 scenarios were related to caregivers with a moderate-to-severe burden. Specifically, there were eight scenarios for patients with three chronic diseases which could be further categorized into five general rules. Two hundred and fifty scenarios belonging to patients with two chronic diseases could be classified into 16 different combinations from eight chronic diseases of the database.Conclusion: Caregiver’s mood, patients with mild dementia, and patients aged 75– 84 years were associated with a severe caregiving burden. College and above education of the caregiver, the patient aged 85 years or more, and at least one of caregiver’s moods were the variables to result in a moderate-to-severe burden for caregivers caring for patients with three multiple chronic diseases. Moreover, college and above education of the caregiver, mood symptom, age of the caregiver, and age of the patient were important variables for caregivers who had a moderate-to-severe burden taking care of patients with two chronic diseases.Keywords: patients with dementia, multiple chronic diseases, behavior and psychological symptoms of dementia, mood symptom, caregiving burden, dementia collaborative care team, apriori algorithm

ObjectivesThis study aimed to identify factors affecting the psychological well-being of family caregivers of dependent older adults in Italy. Understanding these variables is essential for designing interventions to prevent negative outcomes in at-risk caregivers. The research explored how varying levels of caregiving burden and types of perceived social support influence psychological well-being.MethodsA cross-sectional study was conducted among 387 family caregivers of older adults in the Marche region (Italy) between November 2019 and March 2020. Data were collected via a structured questionnaire assessing psychological well-being (WHO-5 Well-Being Index), caregiving burden, and social support (COPE Index). Statistical analyses were performed using Jamovi software, with a significance threshold set at p

This article discusses a study conducted at a university hospital in Turkey that examined the impact of caregiving burden on the stress levels of family caregivers of heart failure patients. The study found a positive correlation between caregiving burden and caregiver stress, with caregiving burden explaining a significant portion of the change in stress levels. The article recommends providing support for family caregivers, enhancing home care services, and establishing support groups to alleviate caregiver stress. The study also provides insights into the demographics and experiences of caregivers, with middle-aged women who were the children of the patients being the majority. Caregiver stress and burden levels were generally low, but varied based on employment status and income level. The study highlights the importance of social support in reducing caregiver burden and stress. However, it is important to consider that the findings may only be applicable to the specific population studied. [Extracted from the article]

Background: We explored the impact of writing a “Good Things Diary (GTDiary) of Caregiving” on family caregivers’ mental health and their evaluation of caregiving roles. Method: We analyzed data from 27 Japanese caregivers for their parents recruited through crowdsourcing. We randomly assigned the participants to one of two groups: the GTDiary of Caregiving group (15 participants) or the Control Diary of Caregiving group (12 participants). We instructed both groups to write a diary for 14 days. Pre- and post-diary questionnaires assessed participants’ well-being, caregiving burden, positive evaluations of caregiving, and stress levels. Results: We observed significant improvements in well-being and positive evaluations of caregiving only in the GTDiary of Caregiving group, which had higher well-being and more positive evaluations of caregiving after keeping the diary. However, both groups experienced reductions in caregiving burden and stress. Limitation: Our group of participants included children and stepchildren of caregivers since we made use of crowdsourcing services. Additionally, this study had a mostly male representation among participants, which does not match with the higher occurrence of female family caregivers in Japan. Consequently, the study's participants may not fully reflect the broader population of family caregivers. Conclusions: Writing a caregiving diary helps family caregivers reduce their perceived burden and stress. Focusing on “good things” in caregiving elevates their perception of positive aspects and enhances well-being.

Abstract Background Family caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components. To optimise intervention, we adopt the multiphase optimisation strategy (MOST) to test the implementation fidelity and determine the effect of each component and the interactions between each component and the corresponding outcome. Methods A prospective, assessor-blinded, randomised clinical trial with fractional factorial design using the MOST principle. Two hundred fifty family dementia caregivers will be randomised to one of 16 experimental conditions in a fractional factorial design involving six intervention components: (1) dementia and caregiving education; (2) self-care skills; (3) behavioural symptom management; (4) behavioural activation; (5) modified mindfulness-based cognitive therapy; and (6) support group. The first one is the core component, and the five remaining will be examined. Physical health, caregiver burden, stress, psychological well-being, anxiety and depressive symptoms, and social support will be assessed over the 12-month study period. Following the intention-to-treat principle, linear mixed models and regression analyses will be used to examine the specific effect of the five components and their two-way interactions to propose the most effective combination. Discussion This is the first study adopting the multiphase optimisation strategy to identify the most active and engaging components of a psychological intervention for caregivers of patients with dementia. In view that dementia caregiver interventions are increasingly diversified and complex, such knowledge is important to maximise the intervention efficacy and allow the intervention to be implemented within an efficient timeframe and dosage. The optimisation of caregiver support interventions is critical to enhance the health outcomes of caregivers and care recipients, thereby, delaying possible institutionalisation and reducing the costs of long-term dementia care. Trial registration This study was retrospectively registered in the WHO Primary Registry – Chinese Clinical Trials Registry (ChiCTR2300071235). (Protocol date 30/10/2020; version identifier 2020–2021-0045). Registered on 9 May, 2023. Reporting method SPIRIT guideline was followed. Patient or public contribution No patient or public involvement.

Background: Family caregiver interventions are essential to support dementia caregiving. However, such interventions are typically complex and consist of multiple components. Existing evidence rarely delineates the effectiveness and interactions between individual components. To optimise intervention, we adopt the multiphase optimisation strategy (MOST) to test the implementation fidelity and determine the effect of each component and the interactions between each component and the corresponding outcome. Methods: A prospective, assessor-blinded, randomised clinical trial with fractional factorial design using the MOST principle. Two hundred fifty family dementia caregivers will be randomised to one of 16 experimental conditions in a fractional factorial design involving six intervention components: (1) dementia and caregiving education; (2) self-care skills; (3) behavioural symptom management; (4) behavioural activation; (5) modified mindfulness-based cognitive therapy; and (6) support group. The first one is the core component, and the five remaining will be examined. Physical health, caregiver burden, stress, psychological well-being, anxiety and depressive symptoms, and social support will be assessed over the 12-month study period. Following the intention-to-treat principle, linear mixed models and regression analyses will be used to examine the specific effect of the five components and their two-way interactions to propose the most effective combination. Discussion: This is the first study adopting the multiphase optimisation strategy to identify the most active and engaging components of a psychological intervention for caregivers of patients with dementia. In view that dementia caregiver interventions are increasingly diversified and complex, such knowledge is important to maximise the intervention efficacy and allow the intervention to be implemented within an efficient timeframe and dosage. The optimisation of caregiver support interventions is critical to enhance the health outcomes of caregivers and care recipients, thereby, delaying possible institutionalisation and reducing the costs of long-term dementia care. Trial registration: This study was retrospectively registered in the WHO Primary Registry – Chinese Clinical Trials Registry (ChiCTR2300071235). (Protocol date 30/10/2020; version identifier 2020–2021-0045). Registered on 9 May, 2023. Reporting method: SPIRIT guideline was followed. Patient or public contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present research was to evaluate the quality of life of patients with atopic dermatitis (AD), and that of their mothers. We compared the anxiety and depression scores and caregiving burden of mothers of patients with AD with the same scores of mothers of healthy children. Materials and Methods: A total of 153 patients between the ages of 2 months and 16 years with AD in our clinic, and their mothers, were contained in the patient group. An additional 141 healthy cases between the ages of 2 months and 16 years, and their mothers, were included as the control group. The Children's Dermatology Life Quality Index (CDLQI) was completed according to the children's opinions, and the Infant's Dermatitis Quality of Life Index (IDLQI), Family Dermatology Life Quality Index (FDLQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire, and Zarit Caregiver Burden (ZCB) scale were completed based on the mothers' opinions. Results: We detected a positive relationship between the SCORAD index and the IDLQI, CDLQI, and FDLQI scores of children with AD. We found that anxiety, depression, and caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children (p < 0.0001, p < 0.0001, and p < 0.002, respectively). Also, based on the mothers' responses, we noted a positive correlation among the BDI, BAI, ZCB, and SCORAD index scores. Conclusions: Our study found that the quality of life of patients with AD, and that of their mothers, was negatively affected by the disease. We also found that anxiety, depression levels (not at the clinical diagnosis level, and the caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children. [ABSTRACT FROM AUTHOR]

Abstract Background Informal caregivers of older adults with dementia may experience substantial burdens during their caregiving process, especially when caring for older adults with other comorbid conditions. This study evaluated whether and how comorbidity burden for persons with dementia (PWD) was associated with caregivers’ physical, psychological, social, and financial burden as well as caregiving gain. Methods Data were from 1,065 community-dwelling older adults living with dementia and their primary caregivers in the National Health and Aging Trends Study and the National Study of Caregiving. PWD’s comorbidity burden was measured by the count of chronic conditions and the pattern of comorbidity identified by the latent class analysis (LCA). We considered four domains of caregiving burden—physical, psychological, social, and financial burden. We used linear regressions to identify the unadjusted and adjusted associations between PWD’s comorbidity burden and caregiving burden and gain. Results Of 1,065 PWD, 13.5% had 0–1 and 24.9% had 5 or more number of comorbid chronic conditions, respectively. After multivariable adjustment, an additional chronic condition is associated with an 0.11- and 0.36-point increase in caregivers’ physical and psychological burden, respectively. Caregivers of PWD with 5 or more chronic conditions had a 0.64- and 2.22-point higher score of physical and psychological burden, respectively, than those caring for PWD with 0 or 1 comorbid condition. LCA divided PWD into two classes, a high comorbidity class (69.0%) and a low comorbidity class (31.0%). Caregivers of PWD in the high comorbidity burden class had a 0.46-point higher score of physical caregiving burden than those in the low comorbidity burden class. No significant association was found between care recipients’ comorbidity burden and their caregivers’ social and financial burden or caregiving gain. Conclusions The comorbidity burden of PWD was associated with their caregivers’ physical and psychological caregiving burden. Relevant interventions to manage the comorbid conditions of people living with dementia and support their caregivers are crucial to improving their physical health and psychological wellbeing.

Purpose: To explore caregiving burden, health-related quality of life (HRQOL), stress, and individual resources of parents in the care of children with isolated growth hormone deficiency (IGHD) or idiopathic short stature (ISS). Methods: Focused interview analysis of previously, within the Quality of Life in Short Stature Youth (QoLISSY) project, conducted structured focus group discussions (n=7) with parents (n=33) of children with IGHD/ISS aged 4 to 18 years were performed. Results: 26 out of the 33 parents reported mental stress due to their child's growth disorder. Social pressure and stigmatization were also mentioned as being demanding. Some parents reported having trouble with human growth hormone (hGH) treatment. Several parents wished for parent support groups with other likeminded parents of short-statured children. Conclusion: For physicians, it is essential to understand the parents' caregiving burden, stress, and individual resources in caring for IGHD/ISS children. If an impaired HRQOL is detected, psychological intervention for these parents may be scheduled, and coping mechanisms may be discussed. Furthermore, it seems essential for parents to be educated by their healthcare provider about the possible side effects of hGH treatment or to know where to find evidence-based information about it. [ABSTRACT FROM AUTHOR]

Objectives: The social support of caregivers is fundamental, and their quality of life, mental health, and the burden of caring are related to the social support they receive during their interaction with people. Because the coronavirus pandemic and related quarantine have affected people’s participation and social support, the caregivers’ lifestyle has changed, and they have become more isolated and lonely. This study aims to investigate the mediating role of the burden of care in the relationship between social support and mental health of family caregivers of elderly Iranians with chronic diseases of the nervous system during the coronavirus pandemic. Methods: We recruited a sample of 249 family caregivers of the elderly with Alzheimer, Parkinson, and stroke. The study data were collected by electronic questionnaires of perceived social support of Zimet, Novak care burden, and Goldberg mental health questionnaire. The obtained data were analyzed using the Pearson correlation and structural equation modeling. Results: This study showed that family caregivers experience high social support, a moderate care load, and their mental health is on the verge of illness during the coronavirus epidemic. The results of the Pearson correlation and structural equation modeling showed a positive and significant relationship between social support perceived by caregivers and their mental health, and the burden of care has a mediating role in this relationship. Discussion: Finally, because social support is effective in reducing the distress experienced by caregivers and improving their performance and mental health, future plans and interventions are expected to consider strengthening social support as primary prevention to protect caregivers from mental health symptoms.

PurposeTo explore caregiving burden, health-related quality of life (HRQOL), stress, and individual resources of parents in the care of children with isolated growth hormone deficiency (IGHD) or idiopathic short stature (ISS).MethodsFocused interview analysis of previously, within the Quality of Life in Short Stature Youth (QoLISSY) project, conducted structured focus group discussions (n=7) with parents (n=33) of children with IGHD/ISS aged 4 to 18 years were performed.Results26 out of the 33 parents reported mental stress due to their child’s growth disorder. Social pressure and stigmatization were also mentioned as being demanding. Some parents reported having trouble with human growth hormone (hGH) treatment. Several parents wished for parent support groups with other like-minded parents of short-statured children.ConclusionFor physicians, it is essential to understand the parents’ caregiving burden, stress, and individual resources in caring for IGHD/ISS children. If an impaired HRQOL is detected, psychological intervention for these parents may be scheduled, and coping mechanisms may be discussed. Furthermore, it seems essential for parents to be educated by their healthcare provider about the possible side effects of hGH treatment or to know where to find evidence-based information about it.

Background: Informal caregivers of older adults with dementia may experience substantial burdens during their caregiving process, especially when caring for older adults with other comorbid conditions. This study evaluated whether and how comorbidity burden for persons with dementia (PWD) was associated with caregivers’ physical, psychological, social, and financial burden as well as caregiving gain. Methods: Data were from 1,065 community-dwelling older adults living with dementia and their primary caregivers in the National Health and Aging Trends Study and the National Study of Caregiving. PWD’s comorbidity burden was measured by the count of chronic conditions and the pattern of comorbidity identified by the latent class analysis (LCA). We considered four domains of caregiving burden—physical, psychological, social, and financial burden. We used linear regressions to identify the unadjusted and adjusted associations between PWD’s comorbidity burden and caregiving burden and gain. Results: Of 1,065 PWD, 13.5% had 0–1 and 24.9% had 5 or more number of comorbid chronic conditions, respectively. After multivariable adjustment, an additional chronic condition is associated with an 0.11- and 0.36-point increase in caregivers’ physical and psychological burden, respectively. Caregivers of PWD with 5 or more chronic conditions had a 0.64- and 2.22-point higher score of physical and psychological burden, respectively, than those caring for PWD with 0 or 1 comorbid condition. LCA divided PWD into two classes, a high comorbidity class (69.0%) and a low comorbidity class (31.0%). Caregivers of PWD in the high comorbidity burden class had a 0.46-point higher score of physical caregiving burden than those in the low comorbidity burden class. No significant association was found between care recipients’ comorbidity burden and their caregivers’ social and financial burden or caregiving gain. Conclusions: The comorbidity burden of PWD was associated with their caregivers’ physical and psychological caregiving burden. Relevant interventions to manage the comorbid conditions of people living with dementia and support their caregivers are crucial to improving their physical health and psychological wellbeing. [ABSTRACT FROM AUTHOR]

Objectives: Patients with advanced cancer with incurable diseases are generally cared for by their families in India. There is a lack of data on the perceived caregiver burden, quality of life (QOL) of patients and caregivers in India, especially among cancer patients not on any oncologic management. Material and Methods: We conducted a cross-sectional study among 220 patients of advanced cancer on best supportive care and their respective 220 family caregivers. Our primary objective was to identify a correlation between caregiver burden and QOL. After taking informed consent from both patients and caregivers, we assessed the QOL of the patient using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 Palliative Care (QLQ C15PAL) questionnaire from the patient, assessing the Caregiver Burden using Zarit Burden Interview, assessing the QOL of the caregiver using the WHO QOL BREF Questionnaire, in a single session during their routine follow-up in the Palliative Care Clinic of our institution. Results: We noticed a statistically significant negative (Spearman) correlation between the Caregiver Burden as assessed by Zarit Burden Interview (ZBI) and the psychological (r = -0.302, P < 0.01), social (r= -0.498, P < 0.01) and environmental (r = -0.396, P < 0.01) domains of the WHO QOL BREF Questionnaire. Caregiving Burden as assessed ZBI total score was noted to have a statistically significant negative correlation with physical functioning (r = -0.37, P < 0.01), emotional functioning (r = -0.435, P < 0.01) and global QOL scores (r = -0.499, P < 0.01) assessed from the patient using the EORTC QLQ C15 PAL questionnaire. It also had a statistically significant small positive correlation with EORTC QLQ C15 PAL symptom scores, such as dyspnoea, insomnia, constipation, nausea, fatigue and pain. The median caregiver burden score was 39, showing higher burden as compared to previous studies. Caregivers who were spouses of the patient, illiterate, homemakers, with low-income families reported higher burden. Conclusion: A high perceived caregiving burden is associated with impaired QOL in family caregivers of advanced cancer patients on best supportive care. Multiple patient related factors and demographic factors tend to affect burden of the caregiver. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present research was to evaluate the quality of life of patients with atopic dermatitis (AD), and that of their mothers. We compared the anxiety and depression scores and caregiving burden of mothers of patients with AD with the same scores of mothers of healthy children. Materials and Methods: A total of 153 patients between the ages of 2 months and 16 years with AD in our clinic, and their mothers, were contained in the patient group. An additional 141 healthy cases between the ages of 2 months and 16 years, and their mothers, were included as the control group. The Children’s Dermatology Life Quality Index (CDLQI) was completed according to the children’s opinions, and the Infant’s Dermatitis Quality of Life Index (IDLQI), Family Dermatology Life Quality Index (FDLQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire, and Zarit Caregiver Burden (ZCB) scale were completed based on the mothers’ opinions. Results: We detected a positive relationship between the SCORAD index and the IDLQI, CDLQI, and FDLQI scores of children with AD. We found that anxiety, depression, and caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children (p < 0.0001, p < 0.0001, and p < 0.002, respectively). Also, based on the mothers’ responses, we noted a positive correlation among the BDI, BAI, ZCB, and SCORAD index scores. Conclusions: Our study found that the quality of life of patients with AD, and that of their mothers, was negatively affected by the disease. We also found that anxiety, depression levels (not at the clinical diagnosis level, and the caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children.

Mo Yi,1 Di Jiang,2 Yuanmin Jia,1 Wei Xu,3 Haixia Wang,1 Yizhang Li,1 Zeyi Zhang,1 Jingjing Wang,1 Ou Chen1 1School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People’s Republic of China; 2Peking Union Medical College Hospital, Beijing, 100730, People’s Republic of China; 3Department of Psychology, Shanghai Normal University, Shanghai, 200234, People’s Republic of ChinaCorrespondence: Ou ChenSchool of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua xi Road, Lixia District, Jinan City, Shandong Province, People’s Republic of ChinaTel +86 53188382000Email chenou@sdu.edu.cnPurpose: Caregivers of COPD patients experience various caregiving burden, which is related to their quality of life. We aimed to explicitly explore whether social support and negative coping styles play the chain mediating roles in the relationship between the caregiving burden of caregivers of COPD patients and their health-related quality of life.Methods: We conducted a multicenter cross-sectional survey in four hospitals using a convenience sample. Participants who met the inclusion criteria completed five relevant scales, including a sociodemographic scale. One-way ANOVA and Pearson’s method were used to analyze the data accordingly, and chain mediated effect values were estimated by bootstrap method to determine whether the model holds.Results: Among the 201 caregivers who participated in this study, the mean age was 55.94 years, most of them were female (61.2%), the mean caregiving burden score was 52.39 ± 14.65, and the quality of life score was 37.97 ± 3.55. Among them, age, gender, education, relationship with the patient, and the number of chronic diseases were the main factors affecting the quality of life score of the caregivers. According to Pearson results, there was a negative correlation between quality of life and caregiving burden, and negative coping styles. The model result showed that caregiving burden could directly and negatively predict quality of life, and also predict quality of life through the chain mediation of social support and negative coping styles.Conclusion: In China, caregivers of patients with COPD experience severe levels of caregiving burden and low quality of life. The combination of adequate perceived social support and lower negative coping can be effective in alleviating caregiving burden and improving their quality of life. Therefore, healthcare professionals should provide targeted guidance to caregivers with the help of social support and interventions that regulate negative coping styles.Keywords: COPD, caregiving burden, quality of life, social support, negative coping styles, cross-sectional study

Background: We use Pearlin's Stress Process Model to examine the objective stressors and subjective burdens of caregiving among family members who care for people with Alzheimer's disease. We ask how these factors are related, whether and how these factors are related to caregivers’ depressive symptoms, and whether their impact on caregivers’ mental health is reduced by caregivers’ informal resources. Methods: OLS regression analyses were used to examine the processes hypothesized by the stress process model using baseline and screen data from the Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) study. Analysis was conducted using R. Results: Social structural disadvantages have little effect on the stress of caregiving. However, women experience greater subjective burden and greater depressive symptoms. The most important objective stressor is the care recipient's behavior problems, but its effects are mostly explained by subjective burden. Subjective burden tends to deplete caregivers’ informal psychosocial resources, but this does not explain why subjective burden is the most important determinant of depressive symptoms. Informal psychosocial resources do not play an important role in reducing the impact of caregiving stress on depressive symptoms. Discussion: This study suggests that without a full understanding of the effects of the burden of caregiving, any interventions or preventive actions will be of limited utility. Researchers and policymakers should consider the utility of providing tangible services to offset the negative impact of caregiving.

Objectives: The social support of caregivers is fundamental, and their quality of life, mental health, and the burden of caring are related to the social support they receive during their interaction with people. Because the coronavirus pandemic and related quarantine have affected people's participation and social support, the caregivers' lifestyle has changed, and they have become more isolated and lonely. This study aims to investigate the mediating role of the burden of care in the relationship between social support and mental health of family caregivers of elderly Iranians with chronic diseases of the nervous system during the coronavirus pandemic. Methods: We recruited a sample of 249 family caregivers of the elderly with Alzheimer, Parkinson, and stroke. The study data were collected by electronic questionnaires of perceived social support of Zimet, Novak care burden, and Goldberg mental health questionnaire. The obtained data were analyzed using the Pearson correlation and structural equation modeling. Results: This study showed that family caregivers experience high social support, a moderate care load, and their mental health is on the verge of illness during the coronavirus epidemic. The results of the Pearson correlation and structural equation modeling showed a positive and significant relationship between social support perceived by caregivers and their mental health, and the burden of care has a mediating role in this relationship. Discussion: Finally, because social support is effective in reducing the distress experienced by caregivers and improving their performance and mental health, future plans and interventions are expected to consider strengthening social support as primary prevention to protect caregivers from mental health symptoms. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the level of awareness of elderly primary caregivers of being at physical and mental health risk due to their caregiving role, as well as to examine the impact of sociodemographic characteristics, patient care characteristics, and situational variables on caregivers' awareness. Data were collected by interview of a sample of primary caregivers aged 60+. A total of 202 primary caregivers responded positively, representing a response rate of 65% (202/311). We found a low–moderate level of awareness. The final multivariate regression analysis (F (12, 179) = 21.26, p < 0.000) revealed six variables, out of nearly 30, that are associated with a high percentage (59%) of the variability of caregivers' awareness, namely caregiving burden, caregivers' self-rated health, patient's disease severity, caregiver gender, number of children, and familial relation to the patient. Action may be taken to raise caregivers' awareness. Such interventions would possibly contribute to the quality of life and health of caregivers, enable the optimal treatment of the patient, and reduce the costs imposed on the health system and society in general. [ABSTRACT FROM AUTHOR]

Family plays a vital role in the lives of individuals living with mental illnesses like schizophrenia. Schizophrenia is a severely disabling mental illness which affects the functioning of family caregivers. Family caregivers of individuals with schizophrenia have received significant consideration in recent years due to robust family involvement in caregiving of ill individuals. The family environment reflects the estimate of psychosocial factors that anticipate the prognosis of illness. Not surprisingly, family caregiving is a prominent support system that displays diverse roles regarding caregiving of individuals with mental illness; however, it has been stayed overlooked by the mental health practitioners. Family caregivers of individuals living with schizophrenia have to deal with a number of problems, such as associated stigma, burnout and reduced quality of life. These problems are result from apparent role of caring when combined with inefficient support system and unproductive ways of coping. Subsequently, may affect the biopsychosocial integrity and quality of life of caregivers. It is now well recognised concern for a mental health professional to acknowledge various dimensions of caregiving and cater the needs associated with family caregivers of individuals with schizophrenia. This review article used a descriptive approach to develop qualitative themes of different dimensions of caregiving from the review of literature. This is a retrospective study which has given an overview of different dimensions of caregiving in context of individuals living with schizophrenia. It is important to pursue further research on this neglected public health concern of caregiving. [ABSTRACT FROM AUTHOR]

Abstract Background Informal caregivers of persons with dementia often experience elevated levels of caregiving burden. However, existing studies tend to use a variable-centered approach to explore it. This study aims to understand the caregiving burden of informal caregivers of persons with dementia in Singapore through a combination of variable-centered and person-centered analytical approaches, and explore the correlates of identified factors and latent classes of caregiving burden. Methods Zarit Burden Interview was used to gauge the caregiving burden of 282 primary informal caregivers of persons with dementia recruited through convenience sampling in Singapore. Factor analysis and latent class analysis were conducted to identify the latent factors and the latent classes of Zarit Burden Interview, followed by multiple linear regression and multinomial logistic regression to explore their significant correlates. Results The analyses suggested a 17-item 3-factor structure for Zarit burden interview and three mutually exclusive caregiving burden classes. Regression analyses found that caregiving related variables especially care recipients’ memory and behaviour problems were correlated with both the factors and latent classes of caregiving burden. Conclusions The combination of these two approaches suggests that caregivers experiencing higher burden on one domain are likely to experience higher burden on the other two domains. This further supports the point that more attention should be given to caregivers who experience an overall high burden. Future research could explore the generalizability of our findings among caregivers elsewhere and explore the type of support needed by caregivers, especially those experiencing high burden.

Yu-An Chen,1,* Cheng-Chen Chang,1,2,* Wen-Fu Wang,3,4,* Ya-Sian Lin,5 Kai-Ming Jhang,3 Tzu-Ying Lo,5 Hsin-Hung Wu5– 7 1Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan; 2School of Medicine, Chung Shan Medical University, Taichung City, Taiwan; 3Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; 4Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan; 5Department of Business Administration, National Changhua University of Education, Changhua, Taiwan; 6Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan; 7Faculty of Education, State University of Malang, Malang, East Java, Indonesia*These authors contributed equally to this workCorrespondence: Hsin-Hung WuNational Changhua University of Education, No. 2 Shida Road, Changhua City, 500, TaiwanTel +886 4 7232105 ext. 7412Fax +886 4-7211292Email hhwu@cc.ncue.edu.twPurpose: This study examined the attributes causing higher burdens for caregivers caring for female patients with Alzheimer’s disease by analyzing a combination of various variables, including demographic data, dementia severity, and neuropsychiatric symptoms.Patients and Methods: This study included 99 female patients with Alzheimer’s disease who were cared for by the dementia collaborative care team at Changhua Christian Hospital, Taiwan. Neuropsychiatric symptoms used in this study included affections (9 types), behavior symptoms (9 symptoms), and psychological symptoms (3 symptoms). The Apriori algorithm was employed to identify association rules that reveal the relationships among demographic data, dementia severity, neuropsychiatric symptoms, and caregivers’ burden.Results: A total of 185 rules were determined, including 51 rules with little or no burden, 108 rules with mild to moderate burden, and 26 rules with moderate to severe burden. The major findings are as follows. Neuropsychiatric symptoms were associated with varying degrees of caregivers’ burden among female patients aged 75 to 84 years with mild dementia. Crying spells and aggression were specifically associated with a moderate to severe burden. Delusion was associated with a mild to moderate and moderate to severe burden. Dysthymia and depression were associated with little or no burden to moderate to severe burden.Conclusion: Clinicians can provide early interventions to reduce the burden of caregivers caring for female patients with Alzheimer’s disease and can refer caregivers for timely assistance to reduce their burden.Keywords: Alzheimer’s disease, female patients, female patients with Alzheimer’s disease, neuropsychiatric symptom, Apriori algorithm, caregiving burden

Kai-Ming Jhang,1,* Wen-Fu Wang,1,2,* Hsin-Fang Chang,3,* Ming-Che Chang,4 Hsin-Hung Wu3,5,6 1Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; 2Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan; 3Department of Business Administration, National Changhua University of Education, Changhua, Taiwan; 4Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan; 5Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan; 6Faculty of Education, State University of Malang, Malang, East Java, Indonesia*These authors contributed equally to this workCorrespondence: Hsin-Hung Wu Email hhwu@cc.ncue.edu.twPurpose: The aim of this study was to elucidate the factors and caring scenarios associated with a moderate to severe care burden in the caregivers of patients with vascular cognitive impairment (VCI).Patients and Methods: This cross-sectional study included 158 patients with VCI and their caregivers who were managed by the dementia collaborative care team at Changhua Christian Hospital, Taiwan. Gender, age, clinical dementia rating, walking ability, behavioral symptoms, and psychological symptoms were the variables from the patients with VCI. Age, marital status, relation to the VCI patient, education, employment status, help of key activities, type of primary care, frequency of care, ZBI (Zarit burden interview) caregiving burden, and caregiver’s mood were the evaluated variables for the caregivers. The Apriori algorithm was used to identify the attributes that resulted in different caregiving burdens from a comprehensive viewpoint of both VCI patients and their caregivers.Results: A total of 1193 rules were identified with 1134 rules belonging to caregivers with a mild to moderate burden and 59 rules belonging to caregivers with a moderate to severe burden. Seven general rules were created based on a summary of these 59 rules. The results showed that an employed female caregiver who was taking care of her husband alone for ≥ 6 days per week, and who was helping with all key activities was likely to experience a moderate to severe burden when the patient had VCI. Moreover, if the caregiver had a relatively low education level and expressed an abnormal mood during the assessment, this increased the likelihood of the caregiver having a moderate to severe burden.Conclusion: The caregiver’s gender, relation to the care recipient, education level, mood status, employment status, and care loading were associated with a higher burden of care for caregivers of patients with VCI. Therefore, a dementia care team should provide personalized training for caregivers about the disease, care skills for specific behaviors and psychological symptoms of dementia (BPSD), and strategies to cope with their own feelings. Caregivers should also be referred to appropriate social resources, such as support groups or respite care.Keywords: vascular cognitive impairment, dementia, caregivers, caregiving burden, Zarit burden interview, caring scenario, Apriori algorithm

Family plays a vital role in the lives of individuals living with mental illnesses like schizophrenia. Schizophrenia is a severely disabling mental illness which affects the functioning of family caregivers. Family caregivers of individuals with schizophrenia have received significant consideration in recent years due to robust family involvement in caregiving of ill individuals. The family environment reflects the estimate of psychosocial factors that anticipate the prognosis of illness. Not surprisingly, family caregiving is a prominent support system that displays diverse roles regarding caregiving of individuals with mental illness; however, it has been stayed overlooked by the mental health practitioners. Family caregivers of individuals living with schizophrenia have to deal with a number of problems, such as associated stigma, burnout and reduced quality of life. These problems are result from apparent role of caring when combined with inefficient support system and unproductive ways of coping. Subsequently, may affect the biopsychosocial integrity and quality of life of caregivers. It is now well recognised concern for a mental health professional to acknowledge various dimensions of caregiving and cater the needs associated with family caregivers of individuals with schizophrenia. This review article used a descriptive approach to develop qualitative themes of different dimensions of caregiving from the review of literature. This is a retrospective study which has given an overview of different dimensions of caregiving in context of individuals living with schizophrenia. It is important to pursue further research on this neglected public health concern of caregiving.

Abstract Background The use of home health care (HHC) is increasing worldwide. This may have an impact not only on patients and their caregivers’ health but on care resource utilization and costs. We lack information on the impact of HHC on the broader dimensions of health status and care resource utilization. More understanding of the longitudinal HHC impact on HHC patients and caregivers is also needed. Moreover, we know little about the synergy between HHC and social care. Therefore, the present study aims to observe longitudinal changes in health, care resource utilization and costs and caregiving burden among HHC recipients and their caregivers in Taiwan. Methods A prospective cohort study “Home-based Longitudinal Investigation of the Multidisciplinary Team Integrated Care (HOLISTIC)” will be conducted and 600 eligible patient-caregiver dyads will be recruited and followed with comprehensive quantitative assessments during six home investigations over two years. The measurements include physical function, psychological health, cognitive function, wellbeing, shared decision making and advance care planning, palliative care and quality of dying, caregiving burden, continuity and coordination of care, care resource utilization, and costs. Discussion The HOLISTIC study offers the opportunity to comprehensively understand longitudinal changes in health conditions, care resource utilization and costs and caregiving burden among HHC patients and caregivers. It will provide new insights for clinical practitioners and policymakers. Trial registration ClinicalTrials.gov Identifier is NCT04250103 which has been registered on 31st January 2020.

Objective: Caregiving burden is defined as a specific level of pressure and problems expressed by caregiver or family, which involves a range of psychological, emotional, social and economic problems. Further, satisfaction is described as the level of the mental happiness, self-confidence and usefulness sensed by caregiver about his/her own caregiving behaviour. The present study aimed to assess the psychometric properties of the Persian version of caregiving satisfaction (SCR) and caregiving burden of grandchildren scales (BCR) among grandparent population by considering the lack of a Persian tool for their measurement. Method: This cross-sectional, descriptive-analytic study was conducted on 70 grandparents who were selected through convenience sampling among the individuals referred to the healthcare centres of five southern cities in Iran Shiraz, Sepidan, Fasa, Jahrom, and Borazjan from April to August, 2019. The questionnaires were filled out by individual interview with participants and the data were analysed through explanatory and confirmatory factor analyses and ROC curve, using SPSS 25 and Amos 21. Results: Two factors were extracted in each questionnaire (Regarding each questionnaire, happiness and responsibility in individual and social satisfaction in caregiving burden were extracted through explanatory factor analysis), representing 78.1 and 75.1% of total variance, respectively. The Cronbach's coefficients alpha related to these subscales were obtained as 0.709-0.859 by indicating an acceptable internal consistency. Conclusion: The Persian version of these questionnaires had appropriate validity and reliability required for measuring satisfaction and caregiving burden of grandchildren among Iranian grandparents and can be used in day care and healthcare centres.

Background: Cancer patients choose to understand at home. Families have an important role in the care of clients specifically at home. Readiness is needed in order to provide optimal care and will be able to improve the quality of life of patients. This literature review aims to see how families are prepared to care for patients with cancer at home. Method: Writing this journal literature uses study literature originating from the database, namely EBSCO, PROQUEST, PubMed, and Google Scholar using the keywords Family Preparedness, Family Caregiver, Symptom Management, Palliative Care, family quality of life, Care Parenting. Using inclusion criteria that contain literature sources taken from 2009 to 2019, inclusion criteria, using English, conformity of approval keywords, linkages between the results of literature research and the discussion raised. Results: There are 4 themes found in this literature review, namely family care in patient care, instruments in measuring family readiness, self-affection for families who care for patients at home, and psycho-education in increasing family readiness to care for patients at home. Conclusion: Family readiness to treat patients at home needs to be considered. Nurses play an important role in providing education to the family in providing patient care at home so that the patient's welfare is fulfilled.

Objective: This study was designed to describe the experiences of family Caregivers' hardiness in caring for Alzheimer's Patients.Methods: The deductive content analysis method was performed between April 2020 and February 2021 in one of the teaching hospitals in Iran. Fourteen family caregivers of Alzheimer's patients were selected using purposive and snowballing sampling and the data were collected by semi-structured interviews. After that, data were analyzed using Elo and Kingas steps.Results: The results of this study showed that based on the experiences of family caregivers, the family caregivers' hardiness in caring for Alzheimer's patients is a feature of cognitive ability to deal with stressful care situations and consists of five dimensions of commitment, control, challenge, communication and culture with 22 generic categories that they were nested into this five dimension.Conclusion: Family caregivers' hardiness is a trait related to the individual and environmental factors, and the prevailing social and cultural conditions affect the individual's perception and experience of hardship and threats, as well as his/her understanding of protective factors and how to use them. Therefore, hardiness should not be interpreted as a simple approach regardless of culture.

Objective: This study was designed to describe the experiences of family Caregivers' hardiness in caring for Alzheimer's Patients. Methods: The deductive content analysis method was performed between April 2020 and February 2021 in one of the teaching hospitals in Iran. Fourteen family caregivers of Alzheimer's patients were selected using purposive and snowballing sampling and the data were collected by semi-structured interviews. After that, data were analyzed using Elo and Kingas steps. Results: The results of this study showed that based on the experiences of family caregivers, the family caregivers' hardiness in caring for Alzheimer's patients is a feature of cognitive ability to deal with stressful care situations and consists of five dimensions of commitment, control, challenge, communication and culture with 22 generic categories that they were nested into this five dimension. Conclusion: Family caregivers' hardiness is a trait related to the individual and environmental factors, and the prevailing social and cultural conditions affect the individual's perception and experience of hardship and threats, as well as his/her understanding of protective factors and how to use them. Therefore, hardiness should not be interpreted as a simple approach regardless of culture. [ABSTRACT FROM AUTHOR]

Background:The long-term care insurance system for the elderly is being implemented as a social support for the elderly in need of care. As of 2022, as the use of adult day care centre among home benefits is on the rise, it is necessary to devise measures to reduce the caregiving burden and family conflicts targeting the caregivers of the elderly who use adult day care centre. Objectives: The purpose of this study is to examine the dual mediating effect of caregiving mastery and self-esteem on the relationship between caregiving burden and family conflict. Methods:In this study, 304 caregivers of the elderly who received a long-term care grad and were using anadult day care centre were targeted. The data were analysed using SPSS PC+ Win. 24.0 and SPSS PROCESS macro 4.1. Applied statistical techniques were descriptive statistics, reliability analysis, correlation analysis, and double mediating effect analysis. Results:First, the age and length of support for caregivers increased the caregiving burden, but the health and economic status of caregivers lowered the caregiving burden and family conflict, and improved caregiving mastery and self-esteem. Second, the caregiving burden of the family caregiver was 2.51 points (out of 5 points) and family conflict was low at 1.85 points (out of 5 points). The parameter, caregiving mastery, was at 3.40 points (out of 5 points) and self-esteem was at 3.40 points (out of 4 points), which is a fairly high level. Third, the higher the caregiving burden, the higher the family conflict was, but the effect of the caregiving burden on family conflict through caregiving mastery and self-esteem was lowered. Conclusions: In order to reduce the impact of the burden of care on family conflict, it is necessary to improve the ability to solve problems in a positive way, such as mastery of caring and selfesteem. This suggests that adult day care centre need to provide caring education for family caregivers to increase their caring skills and provide counselling to improve their self-esteem. [ABSTRACT FROM AUTHOR]

Aims: The growing prevalence of Alzheimer's disease (AD) worldwide has sparked the implementation of national policies to support the growing burden among caregivers of AD/dementia patients. This study aims to quantify and compare the burden of AD/dementia caregivers and evaluate how different living arrangements might impact health outcomes among caregivers in Japan, five European countries (5EU), and the United States (US). Materials and methods: This is a cross-sectional study based on existing data from the 2018 National Health and Wellness Survey. Health outcome measures included health-related quality of life (HRQoL), health state utilities, work productivity and activity impairment (WPAI), and measurement of depression and anxiety amongst AD/dementia caregivers and non-caregivers. Pairwise comparisons between AD/dementia caregivers in Japan, 5EU, and the US were conducted. Multivariate analysis was used to compare across groups within each region, with adjustment for potential confounding effects. Results: A higher proportion of caregivers of AD/dementia patients in Japan were 65 years or older as compared to 5EU and US. On the contrary, female caregivers were significantly higher in the US than Japan and 5EU. The HRQoL and health state utilities index scores amongst AD/dementia caregivers were highest in Japan and lowest in the US. Caregivers in Japan incurred the lowest WPAI among the three regions. The proportion of AD/dementia patients reportedly living in an institution was highest in Japan as compared to the US and EU. Notably, US caregivers whose patients lived in an institution experienced significantly less caregiving burden as compared to caregivers whose patients lived in the community. Conclusions: The caregiving burden among AD/dementia caregivers was substantial across the three regions, with similarities and differences between the West and Japan. The lower caregiving burden in Japan was potentially associated with national policies supporting long-term healthcare and institutionalized nursing care facilities for AD/dementia patients. [ABSTRACT FROM AUTHOR]

Evidence from high-income settings suggests that gardening is associated with reductions in depression, anxiety, and stress. The benefits of gardening are less well understood by mental health practitioners and researchers from low- and middle-income countries. Our study estimated the association between participation in gardening and symptoms of depression, anxiety, and stress among caregivers of people living with dementia in rural, southwestern Uganda. In a cross-sectional study, we interviewed 242 family caregivers of people with dementia to elicit their gardening activities; symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scales); and caregiving burden (Zarit Burden Interview). Linear multivariable regression models estimated the association between participation in gardening and symptoms of depression, anxiety, and stress. Out of 242 participants, 131 (54%) caregivers were involved in gardening. Severe to extremely severe symptoms of depression were less prevalent among those who were involved in gardening compared with those who were not (0 [0%] vs. 105 [95%], P

Background: Informal caregivers of persons with dementia often experience elevated levels of caregiving burden. However, existing studies tend to use a variable-centered approach to explore it. This study aims to understand the caregiving burden of informal caregivers of persons with dementia in Singapore through a combination of variable-centered and person-centered analytical approaches, and explore the correlates of identified factors and latent classes of caregiving burden.Methods: Zarit Burden Interview was used to gauge the caregiving burden of 282 primary informal caregivers of persons with dementia recruited through convenience sampling in Singapore. Factor analysis and latent class analysis were conducted to identify the latent factors and the latent classes of Zarit Burden Interview, followed by multiple linear regression and multinomial logistic regression to explore their significant correlates.Results: The analyses suggested a 17-item 3-factor structure for Zarit burden interview and three mutually exclusive caregiving burden classes. Regression analyses found that caregiving related variables especially care recipients' memory and behaviour problems were correlated with both the factors and latent classes of caregiving burden.Conclusions: The combination of these two approaches suggests that caregivers experiencing higher burden on one domain are likely to experience higher burden on the other two domains. This further supports the point that more attention should be given to caregivers who experience an overall high burden. Future research could explore the generalizability of our findings among caregivers elsewhere and explore the type of support needed by caregivers, especially those experiencing high burden. [ABSTRACT FROM AUTHOR]

Guei-Jhen Yan,1 Wen-Fu Wang,2,3 Kai-Ming Jhang,4 Che-Wei Lin,5 Hsin-Hung Wu6,7 1Secretary Office, Chuanghua Christian Hospital, Changhua, Taiwan; 2Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; 3Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan; 4Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan; 5Medical Divisions of Performance Center, Changhua Christian Hospital, Changhua, Taiwan; 6Department of Business Administration, National Changhua University of Education, Changhua, Taiwan; 7Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan Background: Based on a person-centered care, the relationships between people with dementia and caregivers should be interconnected. There is a need to study what attributes would contribute a higher caregiving burden from a comprehensive viewpoint of care recipients and caregivers.Methods: Apriori algorithm is performed with 12 variables for antecedents and caregiving burden for the consequent from the self-built database of a medical center in Taiwan. The minimum support, minimum confidence, and lift of Apriori algorithm are set to 5%, 90%, and > 1, respectively.Results: Thirty-two rules that satisfy the threshold values are found. Our findings show that clinical dementia rating of care recipients, type of dementia of care recipients, and age of caregivers are not the attributing variables to affect the caregiving burden. In contrast, the highest burden results from a female spouse or a sole caregiver. Moreover, the burden is associated with the type of primary care, frequency of care, and help of key activities. Keywords: Long-Term Care 2.0, help of key activities, type of primary care, frequency of care, association rule, person-centered care

Yu Yu,1 Wei Zhou,2 Zi-wei Liu,3 Mi Hu,1 Zhi-hui Tan,4 Shui-yuan Xiao1 1Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan 410008, China; 2Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; 3Department of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China; 4Department of Gynaecology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China Background: The present study aimed to investigate differences in family burden and caregiver distress in a population of caregivers for schizophrenia, by separating patient gender and caregiver gender.Methods: A sample of 327 primary family caregivers was recruited from a Chinese rural community through a one-stage cluster-sampling method. A cross-sectional design was employed, using validated measures to assess both family burden and primary caregivers’ depression and anxiety.Results: Significant differences by gender were detected in family burden and caregiver distress. Family burden was significantly higher for male patients on the domains of effect on physical and mental health of others, and significantly higher for female caregivers on the domains of financial burden and effect on physical and mental health of others. Caregivers of male patients were more likely to suffer from anxiety than caregivers of female patients (52.7% vs 38.1%, P=0.012); female caregivers were more likely to suffer from depression (51.2% vs 38.6%, P = 0.031) and anxiety (51.6% vs 38.1%, P=0.020) than male caregivers.Conclusion: The results reinforced the expected differences in caregiving experiences of a schizophrenia population by gender, which has implications for the future design of gender-specific interventions to alleviate family burden and caregiver distress. Keywords: gender, caregiving burden, schizophrenia, depression, anxiety

Abstract Background Alzheimer’s disease (AD) dementia, a progressive neurodegenerative disease, exerts significant burden upon patients, caregivers, and healthcare systems globally. The current study investigated the associations between AD dementia patient disease severity and health-related quality of life (HRQoL) of both patients (proxy report) and their caregivers living in Japan, as well as caregiving-related comorbidities such as depression. Methods This cross-sectional study used self-reported data from caregivers of people diagnosed with AD dementia by a healthcare provider in Japan. Caregivers were identified via online panels and invited to participate in an online survey between 2014 and 2015. Caregivers completed survey items for themselves, in addition to providing proxy measures for patients with AD dementia for whom they were caring. Patient and caregiver HRQoL was measured using the EuroQoL 5-Dimension (EQ-5D). Additional outcomes for caregivers of AD dementia patients included the Patient Health Questionnaire (PHQ-9) of depressive symptomology, as well as comorbidities experienced since initiating caregiving for their AD dementia patients. These outcomes were examined as a function of AD dementia severity, as measured by long-term care insurance (LTCI) categories. Bivariate analyses between LTCI and outcomes were conducted using independent t-tests and chi-square tests. Multivariable analyses, controlling for potential confounders, were conducted using generalized linear models (GLMs) specifying a normal distribution. Results Across 300 caregiver respondents, multivariable results revealed that increasing AD dementia severity was significantly associated with poorer patient and caregiver EQ-5D scores and a high proportion of caregivers (30.0%) reported PHQ-9 scores indicative of major depressive disorder (MDD). The most frequent comorbidities experienced after becoming caregivers of AD dementia patients included hypertension (12.7%) and insomnia (11.0%). Depression and other comorbidities did not differ significantly by patient severity. Conclusions The current study provides unique insight into the specific degree of incremental burden associated with increasing AD dementia severity among patients and caregivers alike. Importantly, greater disease severity was associated with poorer quality of life among both patients and caregivers. These results suggest that earlier detection and treatment of AD dementia may provide an opportunity to reduce the burden of disease for patients, caregivers, and society at large.

Aim: Informal caregivers of cancer patients have extensive burdens. They are susceptible for deterioration of their quality of life (QOL). We aimed to assess caregiver burden and QOL of family caregivers of cancer patients receiving chemotherapy admitted in the ward/intensive care unit/high-dependency unit. Materials and Methods: This prospective observational study including 178 caregivers was carried out in a tertiary care hospital. The assessment of caregiving burden was done using the Zarit Burden Interview and its impact on QOL using the WHO BREF QOL questionnaire. Results: The mean age and mean Zarit Burden score of caregivers were 38.98 ± 10.53 and 30.697 ± 8.96, respectively. Of the total, 70.22% of caregivers reported mild-to-moderate burden and 21.38% reported moderate-to-severe burden. On assessment of QOL WHO BREF, the mean general score was 5.79 ± 1.84, physical health score was 49.65 ± 16.07, psychological health 51.85 ± 20.43, social relations 59.38 ± 21.43, and environmental 58.73 ± 17.51. The QOL scores were slightly better in mild-to-moderate burden compared to moderate-to-severe burden but not statistically significant except for social relations (P = 0.053). We did not find any difference in burden scores or QOL between male and female caregivers. Conclusion: Mild-to-moderate burden was seen in 70.22% of caregivers and 21.38% had moderate-to-severe burden. [ABSTRACT FROM AUTHOR]

In this study, a cross-sectional, predictive correlation design was used to identify and test a causal relationship between behavior disturbances, coping, family conflict, self-esteem and social support to caregiver burden among dementia caregivers. A total of 450 caregivers of dementia aged over 18 years were recruited from 4 hospitals in northern Thailand based on selected criteria. Demographic Questionnaire, Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD, The Family Conflict Scale, The Zarit Burden Interview Scale, The Perceived Social Support Questionnaire, The Brief COPE and The Rosenberg Self-Esteem with acceptable reliability coefficients were used to collect data. Data were analyzed using descriptive statistics, Pearson's Product-Moment Correlation and path analysis by structural equation modeling. Results showed that the modified model fitted with the data and explained 58% of the variance in caregiving burden among dementia caregivers. Coping and family conflict had a positive direct effect on caregiving burden (p < 0.001), whereas self-esteem and social support had a direct negative effect on caregiving burden (p < 0.001). Behavior disturbance had a positive indirect effect caregiving burden (p < 0.001) via family conflict. Coping had a positive indirect effect on caregiving burden (p < 0.001) via behavior disturbance and family conflict. Social support had a negative indirect effect on caregiving burden (p < 0.001) via family conflict and self-esteem. The results of this study could be used as a guideline for psychiatric nurses in planning an appropriate intervention program to reduce burden of caregivers of dementia patients in Thailand. [ABSTRACT FROM AUTHOR]

Abstract Background Our ageing society is putting tremendous strain on public health and welfare programs to meet the needs of ageing individuals. Promoting informal caregiving is one way for policymakers to reduce this burden. However, caregiving may be experienced as stressful and is associated with adverse health consequences. While quite a lot of research focuses on caregiving for community-dwelling older adults, little is known about informal care in institutionalised long-term care (ILTC). Therefore, the objectives of this study were: 1) to compare characteristics of informal caregivers and care receivers and caregiver outcomes - at home and in ILTC; 2) to study the association between these characteristics and positive and negative caregiver outcomes; 3) to investigate the moderating effect of the setting (at home vs. ILTC) on these associations. Methods A cross-sectional study was conducted using the TOPICS-MDS DataSet. A total of 5197 Dutch dyads were included. The average age of the care receivers and caregivers was respectively 80.7 years and 63.2 years. Several sociodemographic, health-related and caregiving-related characteristics of care receiver and caregiver and two caregiver outcomes (i.e., subjective burden and care-related quality of life) were included in the analyses. Results Caregivers in both settings experienced comparable levels of subjective burden. Caregivers at home had slightly lower care-related quality of life than caregivers in ILTC. Several care receiver characteristics (i.e., male sex, married/cohabiting, more morbidities/disability, and less self-perceived health/psychological wellbeing) and several caregiver characteristics (i.e., female sex, being younger, living together with the care receiver, more objective burden, less self-perceived health, and more support) were associated with an increase in burden and/or a decrease in care-related quality of life. Some of these associations were stronger for dyads at home compared to dyads in ILTC. Conclusions Informal caregiving does not stop with admission to an ILTC facility. Both settings need an informal caregiving policy, which is (1) tailored to the individual characteristics of care receivers and caregivers; (2) pays attention to the identified risk groups; and (3) reduces the negative caregiver outcomes and emphasizes the positive outcomes at the same time.

Background: The care demands of children with chronic diseases can affect caregivers’ health by imposing caregiving burden to them. The health status of caregivers plays a vital role in the quality of care provided to such children and in their quality of life. Objective: To determine caregiving burden in caregivers and to identify relevant influential factors. Methods: In this cross-sectional study, a total number of 249 caregivers of children with chronic diseases who referred to hospitalization and ambulatory departments of Bandar Abbas, Iran in 2016 were selected using convenience sampling method. The main caregivers who were older than 18 years and provided care to a sick child for at least three months consecutively were included. Caregiving burden was measured using the Caregiver Burden Scale. Data was analyzed SPSS 16 using descriptive statistics, Spearman’s correlation coefficient and Mann-Whitney U test. Results: Mean score of caregiving burden was 1.98 which was close to moderate level. The highest caregiving burden was observed in general strain dimension (2.35), and cerebral palsy imposed the maximum burden to caregivers (2.24). Correlation coefficient revealed that perceived caregiving burden was in connection with children’s and caregivers’ age, duration of disease and caregiving, child’s level of disability, number of family members and income level (p

Background & Aim: Improving the mental health of mothers of children with thalassemia major who experience great caregiving burden, requires an efficient supportive training to be developed and implemented. Therefore, this study aimed to determine the impact of a group supportive training on caregiving burden in the mothers of children with thalassemia major. Methods & Materials: A quasi-experimental study (IRCT2016122731612N1) was conducted on 80 mothers of children with thalassemia, referred to Aliasghar hospital in Zahedan in summer 2016. The mothers were selected through convenience sampling method and divided into two intervention and control groups of 40 each. The intervention group received four sessions of supportive training during four weeks. Data were collected by the Caregiver Burden Inventory. SPSS version 21 and independent t test, paired t-test and the analysis of covariance were used to analyze the data. Results: The mean score of caregiving burden before training in the intervention and control groups were respectively, 86.60±13.55 and 92.37±8.54 and declined to 59.62±9.90 and 89.57±5.83 after the intervention. Furthermore, The caregiving burden score in five dimensions including temporal, developmental, physical, social and emotional was significantly lower in the intervention group than in the control group (P

AbstractBackgroundAlzheimer's disease and related dementias are associated with increasing health burden in low- and middle-income countries. Less well-recognized is the potential health burden experienced by other affected individuals, such as family caregivers. In this study, we sought to profile the burden of care and its association with symptoms of depression and anxiety among informal caregivers of people living with dementia in rural southwestern Uganda.MethodWe conducted a cross-sectional study of 232 family caregivers of people with dementia. The key measured variables of interest were caregiving burden (Zarit Burden Index) and symptoms of depression and anxiety (Depression Anxiety Stress Scales). We fitted multivariable regression models specifying depression and anxiety symptoms as the primary outcomes of interest and caregiving burden as the primary explanatory variable of interest.ResultsFamily caregivers of people with dementia experience significant caregiving burden, with each item on the Zarit Burden Index endorsed by more than 70% of study participants. Nearly half [108 (47%)] of caregivers had Zarit Burden Interview scores >60, suggestive of severe caregiving burden. In multivariable regression models, we estimated a statistically significant positive association between caregiving burden and symptoms of both depression [b = 0.42; 95% confidence interval (CI) 0.34–0.49] and anxiety (b = 0.37; 95% CI 0.30–0.45).ConclusionFamily caregivers of people with dementia in rural Uganda experience a high caregiving burden, which is associated with symptoms of depression and anxiety. Interventions aimed at reducing caregiving burden may have important collateral mental health benefits.