|
| ||
|
|
||
Caregiving
Kinds of Caregiving Terms modified by Caregiving Selected AbstractsDifferential development of infants at risk for psychopathology: the moderating role of early maternal responsivityDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2001Manfred Laucht PhD The development of behaviour problems in infants born with biological risk (low birthweight) and psychosocial risk (psychosocially disadvantaged family) was studied in a sample of 347 children (171 males, 176 females) at the ages of 2, 4:6, and 8 years. In the search for factors that moderate the effects of early risks, the role of early responsive caregiving was examined. Results indicate that infants at psychosocial risk exhibited both more externalizing and internalizing problems across ages than infants not at psychosocial risk, while no overall differences were apparent between normal-and low-birthweight groups. With one exception, no interactions between biological and psychosocial risk factors emerged, suggesting that their simultaneous effect is largely additive. Maternal responsivity was found to moderate the effects of low birthweight on hyperkinetic and internalizing problems as well as to influence the consequences of family disadvantage on total problems. These findings stress the importance of early parenting in the behavioural development of at-risk children. [source] Maternal prenatal anxiety, postnatal caregiving and infants' cortisol responses to the still-face procedureDEVELOPMENTAL PSYCHOBIOLOGY, Issue 8 2009Kerry-Ann Grant Abstract This study prospectively examined the separate and combined influences of maternal prenatal anxiety disorder and postnatal caregiving sensitivity on infants' salivary cortisol responses to the still-face procedure. Effects were assessed by measuring infant salivary cortisol upon arrival at the laboratory, and at 15-, 25-, and 40-min following the still-face procedure. Maternal symptoms of anxiety during the last 6 months of pregnancy were assessed using clinical diagnostic interview. Data analyses using linear mixed models were based on 88 women and their 7-month-old infants. Prenatal anxiety and maternal sensitivity emerged as independent, additive moderators of infant cortisol reactivity, F (3, 180),=,3.29, p,=,.02, F (3, 179),=,2.68, p,=,.05 respectively. Results were independent of maternal prenatal depression symptoms, and postnatal symptoms of anxiety and depression. Infants' stress-induced cortisol secretion patterns appear to relate not only to exposure to maternal prenatal anxiety, but also to maternal caregiving sensitivity, irrespective of prenatal psychological state. © 2009 Wiley Periodicals, Inc. Dev Psychobiol 51: 625,637, 2009 [source] Implications of Sibling Caregiving for Sibling Relations and Teaching Interactions in Two CulturesETHOS, Issue 2 2003Jacqueline Rabain-Jamin This article explores the social and cognitive implications of sibling caregiving among the Zinacantec Maya of Mexico and the Wolof of Senegal. Ethnographic video data of sibling caregiving interactions were collected, focusing on children ages three to 13 years interacting with their two-year-old siblings. Sibling relations in both cultures reflect a system of multiage play, the children's sensitivity to age and gender hierarchies, and the older siblings'role as teachers of their younger siblings. Differences in the two groups include more verbal exchanges and wordplay with the two-year-old Wolof children and more overt efforts by older Zinacantec siblings to incorporate the two year olds into their group activity. The data indicate an overall pattern of cultural transmission by which older siblings teach younger ones in the context of caring for them. The pattern is nuanced by each group's social organization and rules for social interaction, exhibited in the children's play. [source] To tell or not to tell: Men's disclosure of their HIV-positive status to their mothers,FAMILY RELATIONS, Issue 2 2005Constance L. Shehan Abstract: Disclosing an HIV diagnosis to his mother may be the first step in a man's successful management of his illness, but it may also lead to added stress due to stigmatization. Analyzing data provided by 166 HIV-positive men who lived in the southeastern United States, we found that the most powerful correlate of disclosure was exposure to HIV through homosexual contact. Additionally, those who had AIDS rather than HIV and exhibited more severe symptoms were significantly more likely to have disclosed to their mothers; older and more highly educated men were significantly less likely to have done so. We discuss the implications of our findings for maternal caregiving to adult sons in middle and later life. [source] Advice Given to Parents on Welcoming a Second Child: A Critical Review,FAMILY RELATIONS, Issue 1 2002Laurie Kramer A review of popular press books and articles for parents published between 1975 and 2000 was conducted to delineate the areas in which the advice given to parents about the transition to a second child is consistent with or diverges from the results of relevant research. Although popular advice reflects available research in certain areas (e.g., encouraging sibling caregiving), research to substantiate other directives (e.g., sibling preparation classes) is lacking. Key research findings about how to promote harmonious sibling relationships often are not represented in popular writings. These results highlight the need for researchers and popular press writers to acknowledge their complementary roles in disseminating information. [source] ,I'm Home for the Kids': Contradictory Implications for Work,Life Balance of Teleworking MothersGENDER, WORK & ORGANISATION, Issue 5 2008Margo Hilbrecht This study explores the experience of time flexibility and its relationship to work,life balance among married female teleworkers with school-aged children. Drawing from a larger study of teleworkers from a Canadian financial corporation, 18 mothers employed in professional positions discussed work, leisure and their perceptions of work,life balance in in-depth interviews. Telework was viewed positively because flexible scheduling facilitated optimal time management. A key factor was the pervasiveness of caregiving, which could result in ongoing tensions and contradictions between the ethic of care and their employment responsibilities. The ideology of ,intensive mothering' meant that work schedules were closely tied to the rhythms of children's school and leisure activities. The different temporal demands of motherhood and employment resulted in little opportunity for personal leisure. Time ,saved' from not having to commute to an office was reallocated to caregiving, housework or paid employment rather than to time for their self. The women also experienced a traditional gendered division of household labour and viewed telework as a helpful tool for combining their dual roles. Time flexibility enhanced their sense of balancing work and life and their perceived quality of life. At the same time, they did not question whether having the primary responsibility for caregiving while engaged in paid employment at home was fair or whether it was a form of exploitation. [source] Cognitive and non-cognitive behaviors in an APPswe/PS1 bigenic model of Alzheimer's diseaseGENES, BRAIN AND BEHAVIOR, Issue 2 2009M. Filali Neuropsychiatric signs are critical in primary caregiving of Alzheimer patients and yet have been relatively ignored in murine models. In the present study, APPswe/PS1 bigenic mice had higher levels of irritability than non-transgenic controls as measured in the touch escape test. Moreover, APPswe/PS1 mice showed poorer nest building than controls and a higher duration of immobility in the forced swimming assay. These results are concordant with the hypothesis of increased apathy and depression-like behavior in an Alzheimer's disease model. In addition, APPswe/PS1 bigenic mice were deficient in retention of passive avoidance learning and left,right discrimination learning, concordant with previous findings in other Alzheimer-like models. [source] Caring for mom and neglecting yourself?HEALTH ECONOMICS, Issue 9 2009The health effects of caring for an elderly parent Abstract We examine the physical and mental health effects of providing care to an elderly mother on the adult child caregiver. We address the endogeneity of the selection in and out of caregiving using an instrumental variable approach, using the death of the care recipient and sibling characteristics. We also carefully control for baseline health and work status of the adult child. We explore flexible specifications, such as Arellano,Bond estimation techniques. Continued caregiving over time increases depressive symptoms and decreases self-rated health for married women and married men. In addition, the increase in depressive symptoms is persistent for married women. While depressive symptoms for single men and women are not affected by continued caregiving, there is evidence of increased incidence of heart conditions for single men, and that these effects are persistent. Robustness checks indicate that these health changes can be directly attributable to caregiving behavior, and not due to a direct effect of the death of the mother. The initial onset of caregiving has modest immediate negative effects on depressive symptoms for married women and no immediate effects on physical health. Negative physical health effects emerge 2 years later, however, suggesting that there are delayed effects on health that would be missed with a short recall period. Initial caregiving does not affect health of married men. Published in 2009 by John Wiley & Sons, Ltd. [source] Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregivingHEALTH ECONOMICS, Issue 5 2006Bernard van den Berg Abstract The incorporation of informal care into economic evaluations of health care is troublesome. The debate focuses on the valuation of time spent on informal caregiving, while time measurement, a related and may be even a more important issue, tends to be neglected. Valid time measurement is a necessary condition for the valuation of informal care. In this paper, two methods of time measurement are compared and evaluated: the diary, which is considered the gold standard, and the recall method, which is applied more often. The main objective of this comparison is to explore the validity of the measurement of time spent on providing informal care. In addition, this paper gives empirical evidence regarding the measurement of joint production and the separation between ,normal' housework and additional housework due to the care demands of the care recipients. Finally, the test,retest stability for the recall method is assessed. A total of 199 persons giving informal care to a heterogeneous population of care recipients completed the diary and the recall questionnaire. Corrected for joint production, informal caregivers spent almost 5.8 h a day on providing informal care. If one assumes that respondents take into account joint production when completing the recall questionnaire, the recall method is a valid instrument to measure time spent on providing informal care compared to the diary. Otherwise, the recall method is likely to overestimate the time spent on providing informal care. Moreover, the recall method proves to be unstable over time. This could be due to learning effects from completing a diary. Copyright © 2005 John Wiley & Sons, Ltd. [source] Mother,child and father,child mutuality in two contexts: consequences for young children's peer relationshipsINFANT AND CHILD DEVELOPMENT, Issue 2 2010Eric W. Lindsey Abstract This study examines the role that context plays in links between relative balance, or mutuality in parent,child interaction and children's social competence. Sixty-three toddlers and their parents were observed in a laboratory play session and caregiving activity (i.e. eating snack). Mutuality was operationalised as the relative balance in (a) partners' compliance to initiations, and (b) partners' expression of positive emotion. Caregivers rated children's social competence with peers, and children's prosocial and aggressive behaviour with peers was observed in their childcare arrangement. Contextual differences were observed in the manifestation of parent,child mutuality, with both mother,child and father,child dyads displaying higher mutual compliance scores in the play context than in the caregiving context. Father,child dyads also displayed higher levels of shared positive emotion during play than during the caregiving context. There were no differences in a way that parent,child mutuality during play and caregiving was associated with children's social competence with peers. Overall, the results suggest that parent,child mutuality is a quality of parent,child interaction that has consistent links to children's peer competence regardless of the context in which it occurs. Copyright © 2009 John Wiley & Sons, Ltd. [source] Mothers' facial expressions of pain and fear and infants' pain response during immunization,INFANT MENTAL HEALTH JOURNAL, Issue 4 2010Rachel E. Horton The goal of the current study was to examine the relationship between mothers' spontaneous facial expressions of pain and fear immediately preceding their infants' immunizations and infants' facial expressions of pain immediately following immunizations. Infants' observations of mothers' faces prior to immunization also were examined to explore whether these observations moderated the effect of mothers' facial expressions on infant pain. The final sample included 58 mothers and their infants. Video data were used to code maternal facial expressions, infants' observations, and infants' expressions of pain. Infants who observed their mothers' faces had mothers who expressed significantly more fear pre-needle. Furthermore, mothers' facial expressions of mild fear pre-needle were associated with lower levels of infants' pain expression post-needle. A regression analysis confirmed maternal facial expressions of mild fear pre-needle as the strongest predictor of infant pain post-needle after controlling for infants' observations of mothers' faces. Mothers' subtle facial expressions of fear may indicate a relationship history of empathic caregiving that functions to support infants' abilities to regulate distress following painful procedures. Interventions aimed at improving caregiver sensitivity to infants' emotional cues may prove beneficial to infants in pain. Future directions in research are discussed. El objetivo del presente estudio fue examinar la relación entre lasespontáneas expresiones faciales de dolor y de miedo de las madres en elmomento inmediatamente anterior a la vacunación de sus infantes, y lasexpresiones faciales de dolor de los infantes inmediatamente después dela vacunación. También se examinaron las observaciones que losinfantes hacían de las caras de las madres antes de la vacunación,con el fin de explorar si estas observaciones servían para moderar elefecto de las expresiones faciales de las madres sobre el dolor de losinfantes. El grupo muestra final incluyó 58 madres y sus infantes. Lainformación en vídeo se usó para codificar las expresionesfaciales maternales, las observaciones de los infantes, y las expresiones dedolor de los infantes. Los infantes que observaron las caras de sus madrestenían madres que expresaban significativamente más miedo antes dela aguja. Es más, las expresiones faciales de las madres de poco miedoantes de la aguja se asociaron con bajos niveles de expresiones de dolor delos infantes después de la aguja. Un análisis de Regresiónconfirmó las expresiones faciales maternales de poco miedo antes de laaguja como el factor de predicción más fuerte del dolor del infantedespués de la aguja, después del experimento de control de lasobservaciones que el infante hacía de las caras de las madres. Lasexpresiones faciales de miedo de las madres más difíciles dedetectar o analizar pudieran indicar una historia de relación con unaprestación de cuidado de más empatía, la cual funciona paraapoyar las habilidades del infante de regular la ansiedad mental despuésde procedimientos dolorosos. Las intervenciones dirigidas a mejorar lasensibilidad de quienes prestan cuidado hacia las señas emocionales delos infantes pudieran demostrar que son beneficiosas para los infantes quesienten dolor. Se discuten las futuras direcciones de la investigación. Le but de cette étude était d'examiner la relation entre lesexpressions maternelles faciales spontanées de douleur et de peurprécédant immédiatement la vaccination de leurs nourrissons etles expressions faciales des nourrissons juste après les vaccinations.Les observations faites par les nourrissons des visages de leur mèreavant la vaccination ont aussi été examinées de fa,on àexplorer si ces observations modéraient l'effet des expressions facialesdes mères sur la douleur du nourrisson. L'échantillon final a inclucinquante-trois mères et leurs bébés. Des données vidéoont été utilisées pour coder les expressions facialesmaternelles, les observations des nourrissons et les expressions de douleurdes bébés. Les bébés qui observaient le visage de leursmères avaient des mères qui exprimaient bien plus de peur "avant laseringue". De plus, les expressions faciales des mères de peurmodérée étaient liées avec des niveaux plus bas d'expressionde douleur "après seringue". Une analyse de Régression aconfirmé les expressions faciales maternelles de peur modérée"avant la seringue" comme étant le facteur de prédiction le plusfort de la douleur du bébé "après la seringue" après avoircontrollé les observations des bébés du visage de leur mere. Lesexpressions faciales subtiles de peur des mères pourraient indiquer unehistoire de relation de mode de soin empathique qui fonctionne afin desoutenir les capacités des bébés à réguler ladétresse après des procédures médicales douloureuses. Lesinterventions qui ont eu pour but d'améliorer la sensibilité du modede soin aux signes émotionnels pourraient s'avérerbénéfiques aux bébés dans la douleur. Des directions futuresde recherches sont discutées. Das Ziel der vorliegenden Studie war es, die Beziehung zwischen denmütterlichen spontanen Gesichtsausdrücke von Schmerz und Angstunmittelbar vor der Impfung ihrer Kinder und der Mimik des Schmerzes derKleinkinder unmittelbar nach Impfungen zu untersuchen. Die kindlicheBeobachtung des Gesichtsausdrucks der Mutter vor der Immunisierung wurdeebenfalls geprüft, um zu erforschen, ob die kindliche Beobachtung dieWirkung der mütterlichen Mimik bei Schmerzen ihres Kindes beeinflusst.Die endgültige Stichprobe umfasste achtundfünfzig Müttern undihre Säuglinge. Video-Daten wurden verwendet, um die mütterlicheMimik, die kindliche Beobachtung der Mutter und Äußerungen desSchmerzes der Säuglinge zu codieren. Kleinkinder die denGesichtsausdruck der Mutter beobachteten, hatten Mütter die signifikantmehr Angst vor der Nadel zum Ausdruck brachten. Darüber hinausführte eine mütterliche Mimik, die wenig Angst vor der Nadel zeigte,zu einem niedrigeren Niveau von Ausdruck von Schmerzen der nach der Impfungim Gesicht der Säuglinge. Eine Regressionsanalyse bestätigt einemütterliche Mimik der milden Angst vor der Nadel, als der stärkstePrädiktor für kindliche Schmerzen nach der Nadel, sofern dieSäuglinge den Gesichtsausdruck der Mutter beobachtet hatten. Einesubtile Mimik der Angst der Mütter deutet auf eine emphatischeMutter-Kind Beziehung hin, die darauf abzielt, die kindliche Fähigkeitder Disstressregualtion nach schmerzhaften Eingriffen zu unterstützen.Maßnahmen zur Verbesserung der Sensibilität der Bezugspersonen mitihren Säuglingen bezüglich der emotionalen Reize, könnten sichals nützlich erweisen, um Kindern in Schmerzsituationen zuunterstützen. Zukünftige Richtungen in der Forschung werdendiskutiert. [source] Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationshipINFANT MENTAL HEALTH JOURNAL, Issue 5 2006Marjukka Pajulo Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article. [source] Improvements in early care in Russian orphanages and their relationship to observed behaviorsINFANT MENTAL HEALTH JOURNAL, Issue 2 2005Christina J. Groark This article describes a unique study that attempts to promote positive social-emotional relationships and attachment between caregivers and children in orphanages in St. Petersburg, Russia. The children who reside in these orphanages are typically between birth and 48 months of age; approximately 50% are diagnosed with disabilities, and approximately 60% leave through foreign adoption. Initially, their orphanage caregivers showed a high level of current anxiety and depression and were detached from and communicated little with the children. Likewise, during baseline observations, the children demonstrated poor attachment behaviors such as indiscriminant friendliness, lack of eye contact with adults, aggression, and impulsive behavior. Two interventions were used in a quasiexperimental design: (a) training of caregivers to promote warm, responsive caregiving and (b) staffing and structural alterations to support relationship building, especially increasing the consistency of caregivers. The methodology required that both the training and staffing interventions be provided to one orphanage, only the training to a second, and neither to a third. (At any one time, ns = 80,120 in each condition.) Initial informal observations reveal positive behaviors for both the caregivers and the children, such as increased two-way conversations, animated and enthusiastic emotional responses, and positive social and language interactions. Early data analyses show an increase in the consistency and stability of caregivers and increased scores for caregivers on every subscale of the HOME Scales. Children showed improvements in physical growth, cognition, language, motor, personal-social, and affect, with children having severe disabilities improving the most. The implications of these findings suggest that training staff with modest educational backgrounds and structural changes are effective, can increase socially responsive caregiving behaviors, and improves social interactions of children, at least temporarily. ©2005 Michigan Association for Infant Mental Health. [source] Brain and behavior interface: Stress and the developing brainINFANT MENTAL HEALTH JOURNAL, Issue 3 2003Megan R. Gunnar Animal studies have shown that mother,infant interactions can have long-term impacts on areas of the brain that regulate fearful behavior and the physiology of stress. Here, the research on human infants and children is reviewed with an eye to whether early experiences have similar effects in our species. Research shows that during the first year, sensitive and responsive caregiving becomes a powerful regulator of emotional behavior and neuroendocrine stress hormone activity in young children. Indeed, quality-of-care effects can be detected for children throughout the preschool years. Reviewed research suggests that temperament affects the likelihood that children will show increases in stress hormones as the quality of their care decreases. Finally, we review the literature on stress hormone activity in children who have been maltreated early in life, and explore the critical question of whether enhancing care later in development can reverse the effects on behavior and neurobiology of early adverse experiences. ©2003 Michigan Association for Infant Mental Health. [source] An attachment perspective on grandparents raising their very young grandchildren: Implications for intervention and researchINFANT MENTAL HEALTH JOURNAL, Issue 2 2003Julie Poehlmann The purpose of this article is to apply an attachment perspective to the growing number of families with grandparents raising grandchildren to increase our understanding of the complexity of intergenerational relationship processes in these families and to guide early intervention and research. It is proposed that, as grandparents take responsibility for their grandchildren, three relationship processes simultaneously occur: (1) disruptions in attachments potentially occur, especially in relationships involving parents, (2) attachment relationships between grandchildren and grandparents develop or are revised, and (3) family members' internal working models of attachment and caregiving are challenged and shaped. To address these processes, attachment theory and research focusing on the formation, disruption, and intergenerational transmission of attachment relationships are reviewed. Conclusions suggest that when grandparents assume responsibility for grandchildren, families may need and be particularly open to a range of interventions. In addition, research focusing on attachment relationships in families of grandparents raising grandchildren is needed. ©2003 Michigan Association for Infant Mental Health. [source] Maternal psychopathology and attachment in toddlers of heavy cocaine-using mothersINFANT MENTAL HEALTH JOURNAL, Issue 3 2001Michael Espinosa The purpose of this study is to examine the relationships among maternal psychopathology, early sensitive caregiving, and security of attachment in a sample of cocaine-using women from environments with high contextual risks that include poverty, low educational attainment, minority status, and single parenthood. Thirty-five women and their offspring participated in the study. Maternal psychopathology, including Axis I and Axis II disorders, was assessed during the prenatal period via a self-report clinical measure. Maternal sensitivity was assessed at 1 month and 6 months postdelivery through rating scales. At 18 months postdelivery, toddlers' attachment to their mothers was assessed via the Strange Situation procedure. Also at 18 months, mothers' level of depression was assessed via a depression inventory. Maternal psychopathology during pregnancy was found to be associated with both early caregiving and attachment. Mothers demonstrating clinical levels of particular Axis II disorders provided less sensitive caregiving, and had toddlers who were more likely to be disorganized/disoriented in their attachments. For Axis I disorders, only clinical levels of prenatal dysthymia were found to be associated with a greater likelihood of secure attachment. ©2001 Michigan Association for Infant Mental Health. [source] The nature of informal caregiving for medically ill older people with and without depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2009Jane McCusker Abstract Objectives To describe patient and caregiver perceptions of the nature of informal caregiving in a sample of older medical inpatients with and without depression. Methods One hundred and fifty-four patient-caregiver pairs were recruited from a larger prospective observational study of three groups of medical inpatients aged 65 and over, with major, minor, and no depression, respectively, and with at most mild cognitive impairment. Interviews were conducted at the time of hospital admission to assess characteristics of patients (disability, comorbidity, perceptions of support) and caregivers (relationship, residence, types of assistance and time spent caregiving). Time spent on the physical tasks of caregiving (assistance with activities of daily living, physical care, transport) was estimated by all caregivers. Time spent on emotional or other support was estimated only for non-coresident caregivers Results In multivariable analyses, neither major nor minor depression was associated with time spent on physical support; major depression was associated with significantly increased time spent by non-coresident caregivers on emotional or other support; minor depression was associated with perceived inadequacy of support. Conclusions Major depression is independently associated with greater time spent by non-coresident caregivers on emotional or other support; minor depression is associated with perceived inadequacy of support. Copyright © 2008 John Wiley & Sons, Ltd. [source] Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairmentINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 6 2005Linda Garand Abstract Background While the deleterious psychosocial and mental health effects of dementia caregiving are firmly established, very little is known about the burdens or psychiatric outcomes of providing care to a spouse with less severe cognitive impairment, such as mild cognitive impairment (MCI). We characterized the nature and level of caregiver burden and psychiatric morbidity in spouses of persons diagnosed with MCI. Methods Interview assessments were completed on a cohort of 27 spouses of persons with a recent diagnosis of MCI. Patient medical records were reviewed to collect information regarding the MCI patient's medical history. Results Respondents endorsed elevated levels of both task-related responsibilities and subjective caregiver burden. Depression and anxiety symptom levels also showed some elevations. Measures of caregiver burden were significantly associated with depression and anxiety levels. In particular, even after controlling for demographic risk factors for distress, nursing task burden was correlated with elevated depressive symptoms, and greater lifestyle constraints were correlated with higher anxiety levels. Conclusions Although caregiver burden and psychiatric morbidity levels were lower than those typically observed in family dementia caregiving samples, our findings suggest that MCI caregivers have already begun to experience distress in association with elevated caregiving burden. These individuals may be ideal targets for selective preventive interventions to maximize their psychological well-being as caregiving burdens related to their spouses' cognitive impairment increase. Copyright © 2005 John Wiley & Sons, Ltd. [source] Family caregiving of persons living with HIV/AIDS in Thailand: Caregiver burden, an outcome measureINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2006Niranart Vithayachockitikhun RN MSN PhD-student The present paper provides an initial picture of HIV/AIDS-affected families. It is evident that families play a major role of support for HIV/AIDS patients in Thai society. Caregiver burden is one of the patient-related outcomes, which is the most common outcome measure in caregiver research. The demands on the family caregivers of these patients are enormous and need to be addressed. The determinants that are associated with caregiver burden such as caregiver characteristics, patient characteristics and social stigma are important for nurses to minimize the burden of care so that appropriate interventions can be developed for persons with HIV/AIDS and family members who share the work of managing their care at home. [source] Older caregivers' coping strategies and sense of coherence in relation to quality of lifeJOURNAL OF ADVANCED NURSING, Issue 6 2007Anna Kristensson Ekwall Abstract Aim., This paper reports a study to investigate coping strategies and sense of coherence in relation to gender, the extent of care, caregiving activities and health-related quality of life in a population-based sample of caregivers aged 75 and over. Background., Caring for another person can be stressful both emotionally, and caregiver burden may affect quality of life in a negative way for the carer. Caregivers' experience of burden may depend on for example, the behaviour of the person cared for, their own health and their sense of coherence. Older people take a great part of caregiving responsibility and thus understanding of their strain and coping is required. Methods., A postal survey was carried out in 2001 with 171 informal caregivers, aged 75 or older. The response rate was 47%. The questionnaire included the Short-Form 12, Carer's Assessment of Managing Index, and Sense of Coherence instrument. Results., Almost 70% of caregivers provided help every day. Higher health-related quality of life was predicted by using self-sustaining coping strategies and by high sense of coherence. Poor economic situation and demanding social and practical support predicted low scores. Conclusion., These findings could help identify those at risk of low quality of life due to caregiving, dysfunctional coping or lack of information about care. Early intervention, including education about alternative coping strategies and practical information, might allow caregivers better possibilities to continue caring with less negative effects on their lives. [source] The needs of family caregivers of frail elders during the transition from hospital to home: a Taiwanese sampleJOURNAL OF ADVANCED NURSING, Issue 3 2000Yea-Ing Lotus Shyu RN PhD The needs of family caregivers of frail elders during the transition from hospital to home: a Taiwanese sample This study explored the needs of family caregivers during the transition from hospital to home. Data from 37 face-to-face interviews with 16 caregivers before discharge and at 2 weeks and 1 month after discharge were subjected to constant comparative analysis. Findings revealed changes in family caregivers' needs during the discharge transition. While preparing to take caregiving responsibility, caregivers reported a need for various types of information. After the discharge, but before home caregiving settled into a pattern, they needed help with caregiving practices. After reaching a pattern for providing family care, caregivers frequently reported needs for continuous emotional support. These findings provide a basis for transitional care services such as discharge planning and home health care services. [source] A Nursing Home in Arab-Israeli Society: Targeting Utilization in a Changing Social and Economic EnvironmentJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Khalid Suleiman MD This article is a case study of the first 10 years of operation (1992,2002) of the Dabouriya Home for the Aged, the first publicly funded culturally adapted nursing home for Israeli citizens of Arab descent. Although 44% of Arab Israelis and 26% of Jewish Israelis aged 65 and older are disabled, in 1999, 4.3% of the Jewish population but only 0.7% of the Arab-Israeli population aged 65 or older lived in long-term care institutions; disabled Arab-Israeli elderly were mainly cared for by families. As Arab-Israeli society modernizes and traditional caregiving is reduced, alternatives must be found for this growing, disabled population. Medical and administrative records of 404 people admitted consecutively to a 136-bed facility over 10 years were analyzed. Two distinct segments of the needy population were served: people with independent activity of daily living (ADL) function but little or no family to provide help with intermediate ADLs and those dependent in ADLs and with health problems, especially dementia. Economic, demographic, and social changes in Arab-Israeli society may mean that traditional caregivers will not be able to adequately care for this highly disabled population. Administrators of the public health system in Israel should be aware of the underutilization of publicly funded long-term care by disabled Arab Israelis and the lack of care alternatives for the population that does use nursing homes, because there may be severe consequences in terms of caregiver burden and social stress when disabled elderly people remain in unsuitable environments. [source] Informal Caregiving Time and Costs for Urinary Incontinence in Older Individuals in the United StatesJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002Kenneth M. Langa MD OBJECTIVES: To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals. DESIGN: Multivariate regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people aged 70 and older (N = 7,443). SETTING: Community-dwelling older people. PARTICIPANTS: National population-based sample of community-dwelling older people. MEASUREMENTS: Weekly hours of informal caregiving, and imputed cost of caregiver time, for community-dwelling older people who reported (1) no unintended urine loss, (2) incontinence that did not require the use of absorbent pads, and (3) incontinence that required the use of absorbent pads. RESULTS: Thirteen percent of men and 24% of women reported incontinence. After adjusting for sociodemographics, living situation, and comorbidities, continent men received 7.4 hours per week of care, incontinent men who did not use pads received 11.3 hours, and incontinent men who used pads received 16.6 hours (P < .001). Women in these groups received 5.9, 7.6, and 10.7 hours (P < .001), respectively. The additional yearly cost of informal care associated with incontinence was $1,700 and $4,000 for incontinent men who did not and did use pads, respectively, whereas, for women in these groups, the additional yearly cost was $700 and $2,000. Overall, this represents a national annual cost of more than $6 billion for incontinence-related informal care. CONCLUSIONS: The quantity of informal caregiving for older people with incontinence and its associated economic cost are substantial. Future analyses of the costs of incontinence, and the cost-effectiveness of interventions to prevent or treat incontinence, should consider the significant informal caregiving costs associated with this condition. [source] Expecting to Work, Fearing Homelessness: The Possible Selves of Low-Income Mothers,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 6 2009Shawna J. Lee We explored the content of possible selves of low-income mothers and the strategies they have to work on their possible selves. Positive expected possible selves focus on getting a job, making ends meet, and caregiving. Negative to-be-avoided possible selves focus on failing to make ends meet, losing (or not getting) jobs, and problems with mental health. Immediate social context,rather than demographic characteristics or global work,family variables,was associated with content of possible selves. Controlling for demographic and work,family variables, job-focused possible selves (and strategies to attain them) were more salient; and caregiving and mental-health-related possible selves were less salient to mothers in job-training programs vs. welfare offices. [source] Seizing possibilities for positive family caregiving in nursing homesJOURNAL OF CLINICAL NURSING, Issue 8 2007Ursula Kellett PhD Aims., This paper explores the ways family members reconstruct meaning through seizing possibilities for positive caregiving in nursing homes. Background., The importance of the ability of family caregivers to adapt and accommodate has been well documented in international family caregiving research. Through engagement in caregiving activities, families learn to modify, adapt and accommodate to changes in their situation and relationships. The support family caregivers experience in learning to accommodate change is crucial in enabling them to reconstruct positive aspects of caregiving in a long-term aged care context. Method., In this study, a hermeneutic phenomenological approach was adopted informed by the philosophical world views of Heidegger and Gadamer. Data collected by in-depth interviews and participant observations, from a purposeful sample of 14 family caregivers, underwent hermeneutic analysis. Results., Five shared meanings associated with seizing possibilities for positive caregiving were revealed: accommodating new and different ways of caring; feeling a part of the nursing home community; seeing the whole picture; learning to care in stress-reducing ways and learning to seize possibilities for self. Conclusion., This paper illustrates how families, through caregiving experience in nursing homes, learn to become active managers, negotiating, accommodating and redeveloping a sense of future viewed with hope, strength and positive anticipation. Relevance to clinical practice., By highlighting what is attributed significance by families, a critical examination of the difficult issues which obstruct the development of meaningful partnerships among nurses, family and their relatives is facilitated. In particular, an examination of tensions at an ideological level supports the need for future research to focus its efforts on examining the ways of implementing nursing care that facilitates partnerships that incorporate and build upon positive and equal relations among staff, families and residents in the context of the nursing home setting. [source] Risk management with suicidal patientsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 2 2006Alan L. Berman The patient who is at-risk for suicide is complex and is difficult to evaluate and treat effectively. Should suicidal behavior occur, the clinician faces the potential wrath of bereaved survivors and their externalized blame exercised through a malpractice suit. The clinician's duty of care to a patient is to act affirmatively to protect a patient from violent acts against self. A finding of malpractice is established if the court finds that this duty was breached, through an act of omission or commission relative to the standard of care, and that this breach was proximately related to the patient's suicidal behavior. This article discusses the standard of care and factors that determine liability in a suicide death of a patient. An extensive list of recommendations for competent caregiving for the at-risk patient and risk management guidelines are then presented. © 2005 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 171,184, 2006. [source] Multiple sclerosis: Empirical literature for the clinical health psychologistJOURNAL OF CLINICAL PSYCHOLOGY, Issue 4 2001David C. Mohr This article reviews the empirical literature related to clinical health psychology in multiple sclerosis (MS). MS is a disease in which the immune system attacks the central nervous system. As such, the interactions between medical and psychological variables are complex, and potentially of considerable importance to patients. Common neuropsychological and psychological problems associated with MS and their etiologies are reviewed. The effects of stress and depression on MS exacerbation are discussed, including clinical, immune, endocrine, and neuroimaging findings. The types of coping common in MS and their effects on adjustment are discussed. The empirical literature on psychological and neuropsychological intervention is reviewed. The small literature on caregiving in MS is also summarized. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 479,499, 2001 [source] Supporting families over the life course: mapping temporalityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 4-5 2003G. Grant Abstract Background The present paper addresses a rather neglected dimension of family caregiving, its temporality. Many accounts of caregiving assume a state of stasis, and therefore, overlook factors which shape the evolving experience of family caregiving over the life course. Methods The paper begins by offering some reflections on theoretical and methodological issues identified by life-course researchers. Results Based both on theoretical propositions and a growing body of empirical evidence, this paper offers a heuristic for thinking about caregiving stages applied to families supporting people with intellectual disability. Conclusions This heuristic is used to suggest further avenues of research and development. [source] Eldercare and job productivity: An accommodation analysisJOURNAL OF LEADERSHIP STUDIES, Issue 4 2008Kenneth C. Sherman Over the next decade, the number of working adults relegated to the role of caregiver for one or more elderly family members will rapidly surge. The emotional, physical, and financial stress of caregiving has already begun to impact the productivity of the employee elder caregiver in the workplace, with estimates placing the annual costs around $30 billion. We can expect costs to grow as workers and their elderly parents continue to age. This particular study addresses the fundamental research question of what affects the job performance of employee elder caregivers. The results support the conclusion that the relationship among caregiving, personal support, organizational accommodation, and job productivity is multidimensional. Organizations attuned to the demands of elder caregiving can work with affected employees to reduce or eliminate declines in job productivity. Future researchers and practitioners can reconsider their research protocols and interventions along a wide continuum of interactions in the employee's home and workplace environments. [source] Generative Uncle and Nephew RelationshipsJOURNAL OF MARRIAGE AND FAMILY, Issue 5 2005Robert M. Milardo This study investigates generativity, or a concern for future generations, in the relationships between uncles and nephews. Using in-depth interviews, 21 uncles and 31 nephews were interviewed in Wellington, New Zealand and Bangor, Maine. Uncles describe themselves as supplements to parents, as friends, or as surrogate parents. Uncles act as mentors by providing nephews with advice and sometimes criticism. They act as intergenerational buffers and family historians by engaging in family work with nephews, providing insights into the behavior of parents or siblings. In turn, nephews provide uncles with insights into the behavior of family members. This study contributes to the literatures on generativity, men and caregiving, and more broadly third-party influences in family relationships. [source] | |||||||||||||||||||||||||||||||