Health-Related Quality of Life and Self-Efficacy of Managing Behavior Problems for Family Caregivers of Vascular Dementia and Alzheimer's Disease Patients

Kuo, Li Min; Huang, Huei‐Ling; Hsu, Wen‐Chuin; Shyu, Yea‐Ing Lotus

doi:10.1159/000360414

Cited by 17 publications

(13 citation statements)

References 27 publications

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“…The final model consisted of educational level, burden and mastery, representing the ‘background and contextual factors’, ‘secondary appraisal’ and ‘mediator’ domains in the stress-appraisal model (22). While the influence of caregiver burden and low education on caregivers’ outcomes is consistent with past studies (34, 36), our findings on the prognostic potential of mastery on caregivers’ risk of depression are novel. Notably, among the three components, mastery contributed the highest to the overall risk score.…”

Section: Discussionsupporting

confidence: 90%

“…Caregiver demographic risk factors included older age (≥65 years) (6), marital status (single) (5), relationship to care-recipient (spouse) (33, 34), working status (33) and sex (female) (34, 35). Social economic status indicators included low education (secondary school or lower) (34, 36) and housing type (public housing). Indicators of care demands such as living with care-recipient (33) and the absence of a domestic helper were also included.…”

Section: Methodsmentioning

confidence: 99%

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Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults

Chan

Lim

Ding

et al. 2019

The Journal of nutrition, health and aging

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Objectives Caregivers of hospitalized older adults experience elevated levels of stress and are at risk of poor health outcomes. There is a lack of screening tools based on self-reported caregiver variables incorporating both protective and risk factors, for early identification of at-risk caregivers. This study reports the development of a caregiver-centric screening tool to identify risk of depression at admission and predicts 3-month risk of depression and quality of life amongst caregivers of older adults with an unplanned admission. Design, Setting and Participants This prospective cohort study was conducted in the medical wards of a tertiary-care hospital from July 2015 to May 2017. We recruited family caregivers of patients aged 65 years and above who fulfilled the following criteria: a) unplanned admission, b) not residing in nursing homes; and c) requiring assistance in activities of daily living. Measurements We examined 11 candidate caregiver variables (mastery, burden and nine demographic variables). Risk of depression (score ≥8 on Hospital Anxiety and Depression Scale (HADS-D) depression subscale) was the primary outcome, and was assessed during the index admission. Logistic regression models were used to identify risk factors and risk scores (weights). The total risk scores were then stratified into three risk levels. Predictive validity of the screening tool was assessed using 3-months post-discharge risk of depression and health-related quality of life (HRQoL). Results The study included 274 caregiver-patient dyads. The mean (SD) age of the caregivers was 59 ( 10 ) years with 33.6% caregivers screening positive for risk of depression. The final model comprised three caregiver variables: mastery, burden and education. The total risk scores ranged from 0 to 6 and showed good discrimination (AUC:0.82, 95% CI: 0.77 to 0.87). Caregivers were classified into low-risk (0–1 points), intermediate-risk (2–4 points), and high-risk (5–6 points) groups, with corresponding rates of risk of depression (HADS-D≥8) of 10.7%, 44.6% and 73.3%, during admission. Relative risk rates of the intermediate- and high-risk group using the low-risk group as reference were 4.16 and 6.84 respectively. At 3-months post-discharge, the rates of caregivers at risk of depression or having poor HRQoL also increased corresponding to the three risk levels as per baseline, supporting the predictive validity of the tool. Conclusions/Implications The caregiver-centric tool is a novel, practical, self-administered, relatively brief caregiver-centric instrument that can be used for rapid screening and stratification of caregivers at risk of depression. Uniquely, the tool comprised of assessment of protective factor (mastery) in addition to risk factors to provide a holistic assessment of the caregiver. It can be incorporated as part of older adults’ admission evaluation so that promp...

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults

Chan

Lim

Ding

et al. 2019

The Journal of nutrition, health and aging

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“…Our research was targeted at exploring the influencing factors associated with HRQOL among family caregivers of patients with AD. Similar to other national studies, 6,18 the present study investigated the low scores of HRQOL in AD patientsʼ caregivers in China; the average HRQOL score was obviously lower than the general population, a relative part of caregivers were dissatisfied with their quality of life, and found that the level of burden, chronic diseases of caregivers, social support, and neuropsychiatric symptoms of patients were correlated with HRQOL.…”

Section: Discussionsupporting

confidence: 70%

“…However, they often neglect their own care, have been in a state of long-term depression, conceal their inner true feelings, ultimately resulting in affects to their physical and mental health. 6 Most studies conducted in Western populations showed three-quarters of family caregiversʼ social lives have been affected, with 60% of caregivers reported having psychological barriers; 70% of caregivers suffer from pessimism and nervousness, and a considerable number of people feel fatigue, depression and loneliness. 7,8 In recent years, academics have begun to pay attention to health-related quality of life (HRQOL) of caregivers.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with health‐related quality of life among family caregivers of people with Alzheimer's disease

et al. 2020

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Aim Based on the ageing population and the inadequate healthcare system in China, the majority of care for patients with Alzheimerʼs disease (AD) is provided by family caregivers. Caregivers suffer a long‐term heavy care burden and pressure, which affects their physical and mental health. The present study aims at investigating health‐related quality of life (HRQOL) among family caregivers of AD patients and exploring its influencing factors. Methods This study included 206 family caregivers (76 male, 130 female) of AD patients recruited from one Tier 3 hospital, one psychiatric hospital, two gerocomiums and three communities in Ganzhou city, Jiangxi Province, China. Measures included the World Health Organization (WHO) Quality of Life (WHO/ QOL‐BREF) questionnaire, Zarit burden of care scale (ZBI), and social support rating scale (SSRS).We performed face‐to‐face or telephone interviews with patients and caregivers. The association between possible factors and changes in HRQOL was examined through stepwise multiple regression analysis. Results The majority of family caregivers felt moderate to severe level of burden. The average HRQOL score was 54.24 ± 10.36. The mean SSRS score was 30.4 ± 10.9. The average ZBI score was 41.2 ± 12.8. The HRQOL of family caregivers of AD patients was negatively correlated with the neuropsychiatric questionnaire score, ZBI score, and chronic diseases of caregivers (P < 0.05), and positively correlated with the SSRS score (P < 0.05). Conclusion Reduced QOL was highly prevalent among AD patient family caregivers, and the level of burden, neuropsychiatric symptoms of patients, social support, and chronic diseases of caregivers were factors associated with HRQOL, and the effect of care burden is greatest. Interventions aimed at reducing the level of burden should focus not only on the patient but also on the caregiver.

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“…A lack of confidence about dealing with challenging behavioural needs has been reported to be associated with increased stress in family carers in dementia (e.g. Kuo, Huang, Hsu, & Yea-Ing, 2014). Further research is merited into the impact of the attributions observed in this study on the emotional response of family carers to challenging care needs and on their attempts to manage those needs.…”

Section: Discussionmentioning

confidence: 71%

Relationship continuity and person-centred care in how spouses make sense of challenging care needs

Riley

Achiampong

Hillberg³

et al. 2018

Aging & Mental Health

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Objectives: Some spouses providing care for a partner with dementia experience continuity in the relationship: Despite the changes that have occurred, the person with dementia and the relationship are felt to be essentially the same as they were before the dementia. Others experience discontinuity: The person and the relationship feel very different. Previous qualitative research has suggested that continuity may be linked with the delivery of more person-centred care. Using a mixed-methods approach, the present study aimed to provide a more robust test of this claim. Method: Twenty-six spousal carers completed the Birmingham Relationship Continuity Measure and the Caregiver Hassles Scale, and took part in an interview about their response to challenging care needs. Attributions about the causes of those needs were extracted from the interviews and coded. Codes referred either to dementia as a cause, or to a range of other causes that reflected a more person-centred focus. A measure of person-centred care was obtained by calculating the percentage of the total number of attributions that fell into these more person-centred categories. Results: Consistent with the hypothesis that continuity and person-centred care are linked, those who reported greater continuity reported a significantly higher percentage of personcentred attributions. Conclusions: Person-centred care is important for the well-being of those giving and those receiving the care. Little is currently known about how to support families to be more personcentred. The possibility of supporting person-centred care through enhancing the experience of continuity merits investigation.

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Health-Related Quality of Life and Self-Efficacy of Managing Behavior Problems for Family Caregivers of Vascular Dementia and Alzheimer's Disease Patients

Cited by 17 publications

References 27 publications

Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults

Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults

Factors associated with health‐related quality of life among family caregivers of people with Alzheimer's disease

Relationship continuity and person-centred care in how spouses make sense of challenging care needs

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