Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study

ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

A Systematic Review on Caregiver’s Burden Among Caregivers of Dementia Patients in Malaysia

@#Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.

Qualitative Insights on the Caregiving of Gastrointestinal Cancer Patients with Low Quality of Life Scores

@#Introduction: Caring for gastrointestinal cancer patients can be demanding and to some, caregivers, burdensome; resulting in them having low quality of life (QOL) and thus they may become the next potential patients. Hence, true heartfelt experiences need to be captured to highlight issues and preventive measures that are not voiced out as most often caregiving is done in silence and out of responsibility. Therefore, this study aimed to explore on the caregivers’ insights on how caregiving experience has resulted in their low QOL. Methods: Seven family caregivers were purposively selected from two oncology centres in the Klang Valley, Malaysia for this qualitative case study. The selection was based on the low scores obtained from Malay Caregiver Quality of Life Cancer (MCQOL) questionnaire during an initial cross-sectional study. Following that, in-depth interviews were performed on those selected caregivers. Interview data were triangulated with the questionnaire and observations for validity. Member and expert checking were conducted to ensure credibility and trustworthiness. A thematic content analysis was later performed. Results: Thematic analysis revealed four distinct contributors to the caregivers’ QOL; namely, patients’ financial and stress management; impact towards physical, psychological, social (including relationship) wellbeing, communication; and support from families, organisation and community. Conclusion: The qualitative study discovered evidence for collaborative support needed to ensure better QOL for the caregivers.

Comparison in the rise of Compassion Fatigue and Stress Levels for Male and Female COVID Caregivers

The COVID-19 pandemic has had a significant impact on everyone’s health, particularly the vulnerable populations. One such group is that of informal caregivers. The onset of the pandemic has led to many individuals assuming COVID caregiving responsibilities within their homes. They often already suffer from psychological and physical distress which has risen immensely during the pandemic. The research seeks to examine the rise in the level of Compassion Fatigue and Stress for these COVID caregivers and if their gender has had an impact on the same. In the context of this study, compassion fatigue refers to the condition of emotional and physical exhaustion experienced as a result of helping or wanting to help individuals experiencing trauma (in the case of the pandemic, people suffering from COVID-19). Constant exposure to such trauma can lead to a severely diminished ability to empathize and feel compassion. Eight COVID caregivers, including four males and four female, were interviewed and their responses have been analyzed within this paper. These caregivers are either salaried employees or self-employed professionals.

Caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers: A cross-sectional analytical study

Objectives: Oncology caregivers often endure a significant amount of psychosocial stress while going through the experience of caregiving for their dependents. Exposure to chronic stress disrupts the cardiac autonomic balance and increases the risk of cardiovascular events. There is a paucity of research on the association between caregiving strain and cardiac autonomic status of primary oncology caregivers. This study aimed to assess the cardiac autonomic balance and its association with the levels of perceived strain and quality of life (QOL) of primary oncology caregivers. Materials and Methods: Forty-six individuals (30 males and 16 females) who have been primary caregivers of patients under the treatment for cancer at the Regional Cancer Centre over the past 3 months–1 year were recruited in this cross-sectional study. Cardiac autonomic status was assessed by heart rate variability (HRV) technique. The level of strain perceived and QOL of the study participants were assessed using the Modified Caregiver Strain Index (MCSI) and Caregiver QOL-Cancer (CQOL-C) questionnaires, respectively. Comparison of study parameters based on MCSI scores (low strain vs. moderate-high strain) was done using the Independent Student’s t-test. Spearman rank correlation coefficient test was performed to assess the correlation between sympathovagal balance (Low frequency [LF]/high frequency [HF]) and other study parameters. Multiple linear regression analysis was performed to predict the LF/HF ratio with independent variables MCSI score and CQOL-C score. P < 0.05 was considered statistically significant. Results: Significantly high blood pressure, LF power, LF nu (LF normalised units) and LF/HF ratio were observed among caregivers with moderate-to-high caregiving strain as compared to those with low strain levels, while significantly low HF nu (HF normalised units) and CQOL-C scores were noted among the moderate-to-high caregiving strain subgroup as compared to the low caregiving strain subgroup. LF/HF ratio revealed a significant positive correlation with the level of caregiving strain (r = 0.563, P < 0.001) and a significant negative correlation with the QOL (r = ?0.489, P = 0.001) of caregivers. However, on regression analysis, the level of caregiving strain was found to be a significant predictor of autonomic dysfunction unlike the caregivers’ QOL. Conclusion: Increased caregiving strain is associated with cardiac autonomic imbalance in primary oncology caregivers.

Sentido de coherencia en universitarios: recurso para el cuidado en tiempos de pandemia / The sense of coherence among university students: A resource for care in times of pandemic / Senso de coerência nos estudantes universitários: um recurso para o cuidado em tempos de pandemias

Introducción: El constructo Sentido de Coherencia derivado del modelo salutogénico, permite afrontar factores estresantes a través de activos para mantener una buena salud. Objetivo: Describir el Sentido de Coherencia (SOC-29) en estudiantes universitarios de la ciudad de Manizales como recurso de cuidado en tiempos de pandemia. Materiales y métodos: Se realizó un estudio cuantitativo, descriptivo con una fase asociativa y comparativa, con 566 estudiantes matriculados en universidades públicas y privadas de la ciudad de Manizales, Caldas (Colombia), durante el primer período académico del 2021. La técnica de recolección fue la encuesta online. Para el análisis univariado se realizó distribución de frecuencias, medidas de tendencia central y dispersión, y para el bivariado U de Mann Whitney, H de Kruskal-Wallis y Chi-cuadrado. Resultados: El valor del Sentido de Coherencia osciló entre 58 y 185 puntos, promedio 133.6 ± 24,4 puntos, un 27% de los participantes informó la pandemia afectó negativamente su vida, se encontró asociación estadísticamente significativa p<0,05 entre el cambio en las condiciones de vida y todos los ítems de la escala. Conclusión: La consolidación del Sentido de Coherencia como parte integral de la salud mental de los universitarios los prepara para afrontar cambios en sus condiciones de vida y hace factible direccionar acciones de cuidado en el contexto social, familiar y académico.

Introduction:The construct of the sense of coherence, derived from the salutogenic model, allows people to cope with stressors through resources to maintain good health. Objective: To describe the sense of coherence (SOC-29) among university students in the city of Manizales as a care resource in times of pandemic. Materials and Methods: A quantitative and descriptive study with an associative-comparative phase was conducted with 566 students enrolled in public and private universities in Manizales, Caldas, (Colombia), during the first semester of 2021. The data collection technique was online surveys. For the univariate analysis, frequency distribution and central tendency and dispersion measures were determined. For bivariate analysis, the Mann-Whitney U test, Kruskal-Wallis H test, and Chi-square test were used. Results:The SOC-29 score ranged from 58 to 185 points (mean 133.6 ± 24.4 points), and 27% of the participants reported that the pandemic negatively affected their life, a statistically significant association (p<0.05) was found between the change in living conditions and all the items of the scale. Conclusions: Consolidating the sense of coherence as an integral part of university students' mental health prepares them to cope with changes in their living conditions and makes it feasible to direct care actions in social, family, and academic settings.

Introdução: A construção Sentido de Coerência derivada do modelo salutogênico, permite lidar com os estressores através de ativos para manter a boa saúde. Objetivo: Descrever o Sentido de Coerência (SOC-29) em estudantes universitários da cidade de Manizales, Caldas (Colômbia), como um recurso para o cuidado em tempos de pandemia. Materiais e Métodos: Foi realizado um estudo quantitativo, descritivo com uma fase associativa e comparativa com 566 estudantes matriculados em universidades públicas e privadas na cidade de Manizales, Caldas (Colômbia), durante o primeiro período acadêmico de 2021. A técnica de coleta foi a pesquisa on-line. Para a análise univariada, foram utilizadas a distribuição de frequência, medidas de tendência central e dispersão, e para a análise bivariada foram utilizadas Mann Whitney U, Kruskal-Wallis H e Chi-quadrado. Resultados: O valor de senso de coerência variou de 58 a 185 pontos, média 133,6 ± 24,4 pontos, 27% dos participantes relataram que a pandemia afetou negativamente suas vidas, associação estatisticamente significativa p<0,05 foi encontrada entre mudança nas condições de vida e todos os itens da escala. Conclusões: A consolidação do Senso de Coerência como parte integrante da saúde mental dos estudantes universitários os prepara para enfrentar mudanças em suas condições de vida e torna viável a abordagem de ações de cuidado no contexto social, familiar e acadêmico.

Can Family Carer Groups Help People with Intellectual Disabilities? Applying Focused Ethnography Methods in Community Contexts of Northeastern Thailand

@#Introduction: This study aimed to explore the experience of family carer groups caring for individuals with intellectual disabilities (IDs) in the community contexts of Northeastern Thailand. Materials and Methods: We applied a focused ethnography method with a purposive sampling technique to conduct 35 in-depth interviews (of 14 individuals with IDs, 12 caregiving parents and nine disability group leaders, respectively), which were audio-recorded and transcribed verbatim, then translated from Thai to English. We used content analysis to code the interviews and develop themes. To evaluate the reliability of the coding attempt, we employed data triangulation techniques. Results: Family carer groups seemed to provide benefit to people with IDs and their families by offering support related to information records, the recovery of health and occupational skills development. Conclusion: Family carer groups are an integral part of efforts to support people with IDs. Notably, these groups may facilitate the early formation of long-term parent carer plans, which can better optimise the care and health outcomes of people with IDs in Thailand.

De todas maneras, al final estaremos solos: implicaciones futuras de la decisión de no tener hijos / We'll be alone in the end anyway: future implications of the decision not to have children

Se propone un análisis desde la decisión autónoma de jóvenes adultos y adultos de no ser madres, ni padres, sobre las implicaciones de esta decisión en su futuro en la etapa de la vejez. El estudio se realizó desde el enfoque cualitativo, fenomenológico, a partir de entrevistas en profundidad con personas residentes en Colombia. Se destaca que la decisión de estas personas transgrede los modelos de reproducción social, impactando en las percepciones sobre familia, reproducción y ciclo vital. Adicionalmente se concluye que la responsabilidad en el cuidado de las personas adultas mayores no puede endilgarse a los hijos y que debe construirse una institucionalidad social robusta para la atención de la vejez

An analysis is proposed based on the autonomous decision of young adults and adults not to become mothers or fathers, on the implications of this decision on their future in old age. The study was carried out from a qualitative, phenomenological approach based on in-depth interviews with people living in Colombia. It is highlighted that the decision of these people transgresses the models of social reproduction, impacting the perceptions about family, reproduction and life cycle. In addition, it is concluded that the responsibility for the care of the elderly cannot be placed on the children and that a robust social institutional framework for the care of the elderly must be built.

Study on the effect of self-guidance manual combined with one-to-one training on the knowledge and practice of caregivers of neurosurgery patients / 中国实用护理杂志

Objective@#To assess the impact of self-guidance manual combined with one-to-one training on the knowledge and practice of caregivers of patients in neurosurgery.@*Methods@#Ninety pairs of inpatients and their caregivers in the second Neurosurgery Ward of the First Hospital of China Medical University were randomly selected and divided into two groups, the control group and the research group. The research group trained caregivers with self-guidance manual combined with one-to-one training, while the control group trained caregivers with self-guidance manual. The demographic data of the two groups were recorded. According to the practice test of nursing staff, the number of completed 6 items before and after the training was recorded and compared between the two groups.@*Results@#The study group's caregiver correctly turned over the buckle after 3 months of intervention, correct skin care, correct functional exercise, correct tracheotomy care, and the number of people who correctly sanitized their hands were 35 (94.6%, 35/37), 35 (94.6%, 35/37), 32 (86.5%, 32/37), 25 (67.6%, 25/37), 22 (59.5%, 22/37). The control caregiver correctly turned over the buckle back after 3 months of intervention, correct skin care, correct functional exercise, correct tracheotomy care, and the number of correct hygiene hands washing was 9 (27.3%, 9/33), 7 (21.2%, 7/33), 8 (24.2%, 8/33), 13 (39.4%, 13/33), 9 (27.3%, 9/33). There was a statistically significant difference between the two (χ2 value was 5.58-39.14, P<0.05).@*Conclusion@#Guidance manual combined with one-to-one training can significantly improve the knowledge and skills of caregivers of neurosurgery patients.

Quality of Life and its associated factors among caregivers of patients with dementia – A crosssectional study in Kuching, Sarawak, Malaysia

@#Background: This study aimed to determine the quality of life and its associated factors among caregivers of patients with dementia in Kuching, Sarawak, Malaysia. Methods: This cross-sectional study was carried out among caregivers for dementia patients who visited three main hospitals in Kuching, Sarawak. Using a validated questionnaire, data was obtained based on socio-demographic profile, patient and caregiving characteristics, supports needs by caregivers, and quality of life (QoL) of caregivers modified from Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and Evaluation’s Scale of the Caregiver’s QoL. Results: A total of 217 caregivers participated with response rate of 99.6%, with 67.3% female and 63.1% Chinese. Most respondent provide care for their parents (62.7%), and stay with patients (67.3%). Average duration of care was 4.2 years (SD±3.72). Resource referral (M=3.52, SD±1.334) and education support (M=3.67, SD±1.054) was highest need. Majority respondents experienced little to no burden (59%). Most respondents were not depressed (98.1%). The QoL of respondents was satisfactory (M=41.36, SD±25.840). Gender of caregivers, patients with behavioural and psychological symptoms of dementia, duration of caregiving, respite care need, caregiver disability or illness, belonging support need, education support need were significantly associated with QoL of caregivers (p<0.05). Conclusion: This study on QoL of caregivers of dementia patients in Sarawak, Malaysia shows that it can be influenced by many factors, both at the caregivers’ level as well as the patients themselves. Therefore, intervention should aim at patients and their caregivers, and within community and healthcare settings.

Promoción del cuidado sensible en contextos de riesgo: un estudio de caso en una cuidadora de Ibagué (Colombia) / Promoting Sensitive Caregiving in Risk Settings: A Case Study in a caregiver in Ibagué (Colombia)

Se tuvo como propósito promover la calidad del cuidado de niños/as en situación de riesgo a través de los cambios en la sensibilidad de una cuidadora que vive en condiciones de vulnerabilidad de la ciudad de Ibagué (Tolima). Este estudio se fundamentó en perspectivas teóricas sobre el desarrollo infantil basadas en la teoría del apego (Bowlby, 1958; Carbonell, 2013; Pianta, 1999) y el modelo bioecológico propuesto por Urie Bronfenbrenner (1987, 2005). Se adoptó un método mixto con alcance descriptivo a partir de un estudio de caso único. Los resultados indican que la cuidadora se encontraba expuesta a diferentes factores externos asociados con la exclusión social, lo que posiblemente se relaciona con su alta percepción subjetiva de vulnerabilidad. El nivel de sensibilidad previo a la intervención se encuentra en el extremo negativo (-0.42). Posterior a la intervención, se identificó un aumento (0.60), usando la técnica del videofeedback. Se concluye que la técnica de intervención utilizada muestra resultados favorables con cuidadores expuestos a situaciones de riesgo, por lo que resulta fundamental dirigir futuros estudios e intervenciones hacia adultos cuidadores como principal estrategia para contrarrestar las afectaciones producto de situaciones de adversidad social y emocional, que puedan incidir el desarrollo integral de la infancia.

The aim was to promote the quality of caregiving for children at risk through changes in the sensitivity of adult caregivers. This study was based on theoretical perspectives on child development based on the Attachment Theory (Bowlby, 1958; Carbonell, 2013; Pianta, 1999 and Salinas & Posada, 2014) and the bioecological model proposed by Urie Bronfenbrenner (1987). The study adopted a quantitative method with a descriptive scope of a quasi-experimental type without a control group and a qualitative phase with a descriptive scope based on a case study. The results indicate that the caregiver who participated in the study is exposed to different external factors associated with social exclusion, which possibly is related to its high subjective perception of vulnerability. The level of sensitivity before the intervention is at the negative end (-0.42). After the intervention with the video feedback technique, an increase was identified (0.60). In conclusion, the intervention technique used shows favourable results with caregivers exposed to risk situations, so it is essential to direct the interventions towards adult caregivers as the primary prevention strategy in child mental health.

Caring for you is straining me! -Strain among the informal caregivers of the elderly attending Health Centres of a Coastal City in Karnataka

Background: Census 2011 estimated 104 million elderly in India. Unprecedented demand for informal caregivers of elderly has resulted in physical, emotional and economic difficulties called caregiver strain. Aim & Objective: To determine the association between levels of strain among informal caregivers and the dependency levels of the elderly. Material & Methods: A cross-sectional study during January -March 2018 was conducted in the health centres attached to field practice areas of a tertiary care hospital. Data collection was done using a pre-tested, semi-structured questionnaire after informed consent from elderly and informal caregivers meeting the inclusion criteria. Statistical Analysis used: Data was entered in MS Excel and analysed using SPSS version 20. Percentages and proportions of Activities of daily living (ADL) and informal caregiver strain of Modified Caregivers Strain Index (MSCI) and their scores were expressed in median and interquartile range. Spearman’s Rho was used to determine the association of ADL and MCSI scores. Results: 47.5% of informal caregivers experienced mild stress; 70 % of the 200 elderly were fully functional. Strain level of the informal caregivers showed a negative correlation (0.557) with the dependency level of the elderly. Conclusion: With increasing dependency level of elderly, informal caregiver strain should be assessed.

Study on the relationship between uncertainty in illness and caregiving burden in family members of patients with chronic wounds / 中华烧伤杂志

Objective@#To investigate the current status of uncertainty in illness and caregiving burden in family members of patients with chronic wounds, and to analyze the relationship between them.@*Methods@#A total of 180 patients with chronic wounds admitted to the Department of Emergency of our hospital from October 2017 to March 2018, conforming to the study criteria, were selected by adopting the convenience sampling method. Then one family member who took care of the patients for the longest time and conformed to the study criteria were included in this cross-sectional survey. General Information Questionnaire made by the authors was conducted to investigate the demographic data and wounds of patients, and demographic data of family members. Chinese version of Parent Perception of Uncertainty Scale-Family Member (PPUS-FM) and Caregiver Burden Inventory (CBI) were used to investigate the uncertainty in illness and caregiving burden. Data were processed with multiple linear regression analysis and partial correlation analysis.@*Results@#The effective recovery rate of questionnaire was 91.7% (165/180). (1) The ages of patients were (71±17) years. Among them, there were 89 males and 76 females. The course of chronic wounds was 0.5 to 120.0 months. The wounds were mainly primary occurrence (86.1%, 142 patients), and the main type of wound was pressure ulcer (43.6%, 72 patients). Fifty-seven patients (34.5%) had wound infection. The ages of family members were (56±13) years, and 61.8% (102 people) of them were female. Their daily time of taking care of patients was (10±8) h. (2) The total scores of PPUS-FM of family members were 33 to 125 (88±17) points, mainly in medium level, in which the item score of unpredictability dimension was the highest. (3) The total scores of CBI of family members were 7 to 79 (43±14) points, in which the item score of time-dependence burden dimension was the highest. (4) Uncertainty in PPUS-FM could independently influence 10% of the total variation of caregiving burden in family members of patients (t=3.18, P<0.01). (5) The total scores of PPUS-FM of family members were in significantly positive correlation with the total scores of CBI and scores of physical burden, emotional burden, and social burden, respectively (r=0.33, 0.32, 0.25, 0.36, P<0.05 or P<0.01), while there was no obvious correlation between total scores of PPUS-FM of family members and time-dependence burden/developmental burden (r=0.14, 0.16, P>0.05).@*Conclusion@#There is positive correlation between uncertainty in illness and caregiving burden.

Depressive symptoms in individuals with family members requiring ADL assistance

BACKGROUND@#The number of patients with depressive symptoms worldwide is increasing steadily, and the prevalence of depression among caregivers is high. Therefore, the present study aimed to identify the effects of individuals' caregiving status with respect to their family members requiring activities of daily living (ADLs) assistance on depressive symptoms among those aged 45 or over.@*METHODS@#Data were collected from the 2006-2016 using the Korean Longitudinal Study of Aging surveys. Participants were categorized into three groups based on their caregiving status with respect to family members requiring ADL assistance: whether they provided the assistance themselves, whether the assistance was provided by other caregivers, or whether no assistance was required. We analyzed the generalized estimating equation model and subgroups.@*RESULTS@#A total of 3744 men and 4386 women were included for the analysis. Men who cared for family members requiring ADL assistance had higher depressive symptoms than those with family members who did not require ADL assistance. Among women, participants who had family members requiring ADL assistance that they themselves or others were providing had higher depressive symptoms than those without family members requiring ADL assistance. Subgroup analysis was conducted based on age, job status, regular physical activities, participation status in social activities, and the number of cohabiting generations.@*CONCLUSIONS@#The study results indicated higher depressive symptoms among those with family members requiring ADL assistance and those who care for such family members themselves. This suggests that an alternative to family caregiving is necessary, especially for the elderly, regardless of caregiver sex.

Malestar psicológico en cuidadores principales de pacientes con enfermedad de Alzheimer / Psychological uneasiness in principal caregivers of patients with Alzheimer's disease

RESUMEN Introducción: En el transcurso de la vida todos somos cuidadores de algún modo. Sin embargo, aprender a serlo no surge de forma automática. Con el gradual envejecimiento de la población aumenta el número de casos que necesitan cuidados. La enfermedad de Alzheimer produce la pérdida gradual de la capacidad de cuidar de sí mismo y por ende se necesita la ayuda de un cuidador familiar, quien asume las principales tareas de cuidado y contrae una gran carga física y psíquica. Objetivo: Caracterizar el malestar psicológico que experimentan los cuidadores principales de pacientes con enfermedad de Alzheimer en los estadios leve y moderado. Métodos: Estudio descriptivo en 35 cuidadores principales de pacientes con enfermedad de Alzheimer leve y moderada del policlínico "Carlos Manuel Portuondo", municipio Marianao. La información fue recogida con el Inventario Neuropsiquiátrico validado al castellano, se procesó con distribuciones de frecuencia absoluta y porcentaje. Resultados: En la categoría de mínimo, predominaron la agitación o agresión (20,00 por ciento), las alteraciones del sueño (22,85 por ciento) y los trastornos de hábitos alimentarios (25,71 por ciento). En la categoría ligero, prevalecieron la depresión (20,00 por ciento), las alteraciones del sueño (25,71 por ciento) y los trastornos de hábitos alimentarios (22,85 por ciento). En la categoría de moderado, los síntomas más frecuentes fueron las repeticiones (25,71 por ciento), la depresión y la ansiedad, ambos con un 22,85 por ciento, la apatía y la irritabilidad, con un 20,00 por ciento. En la categoría de severo, el SPC más frecuente fue las repeticiones (20,00 por ciento). Conclusiones: En los cuidadores principales de pacientes con enfermedad de Alzheimer en los estadios leve y moderado predominó el malestar mínimo, ligero y moderado, presentaron mayor malestar ante la presencia de agitación o agresión, alteraciones del sueño, trastornos de hábitos alimentarios, depresión, repeticiones, ansiedad, apatía e irritabilidad(AU)

ABSTRACT Introduction: In the course of our lives, we are all caregivers in some way. However, learning how to be one does not come up automatically. With an increase in population aging, the number of cases of people needing care also increases. Alzheimer's disease produces the gradual loss of the capacity to take care of oneself and therefore there is the need for the help of a family caregiver, who assumes the main caring tasks together with great physical and mental burden. Objective: To characterize the psychological distress experienced by the main caregivers of patients with Alzheimer's disease in the mild and moderate stages. Methods: Descriptive study with 35 main caregivers of patients with mild and moderate Alzheimer's disease of Carlos Manuel Portuondo Polyclinic of Marianao Municipality. The information was collected with the Neuropsychiatric Inventory validated in Spanish, processed with absolute frequency and percentage distributions. Results: In the category minimum, agitation or aggression (20.00 percent), sleep disturbances (22.85 percent) and eating habits disorders (25.71 percent) predominated. In the category light, depression (20.00 percent), sleep disturbances (25.71 percent) and eating habits disorders (22.85 percent) prevailed. In the category moderate, the most frequent symptoms were repetitions (25.71 percent), depression and anxiety, both with 22.85 percent, apathy and irritability, with 20.00 percent. In the category severe, the most frequent SPC was the repetitions (20.00 percent). Conclusions: In the main caregivers of patients with Alzheimer's disease in the mild and moderate stages, the minimum, slight and moderate discomfort prevailed. They presented greater discomfort in the presence of agitation or aggression, sleep disturbances, eating disorders, depression, repetitions, anxiety, apathy and irritability(AU)

Who Cares? Sociodemographic and Health Characteristics of Carers of Older Persons in Jamaica / ¿Quién cuida? Características Sociodemográficas y de Salud de los Cuidadores de Personas Mayores en Jamaica

ABSTRACT Objective: To describe the sociodemographic and health characteristics and implied needs of caregivers to older persons in Jamaica. Method: This was a community-based, nationally representative study in which a sample of 180 caregivers to older persons was interviewed. Findings: Caregivers were aged between 18 and 88 years (mean 50.5; s = 14.7) and most (77%) were informal compared to 23% who were paid to care. There were no differences between urban and rural caregivers with respect to gender, union status, residing with care recipients and holding a regular job while giving care. Urban caregivers were significantly more likely to report attaining secondary education than those in rural communities (χ2 (2) = 7.40, p < 0.05). Over 90% reported they had not received any formal training in caregiving and those ≤ 45 years were more likely than those in age groups ≥ 46 years to say they want to get caregiver training (χ2 (4) = 27.1, p < 0.001). Male caregivers were significantly more likely to report being the 'child/grandchild/in-law' of care recipients than female caregivers, among whom almost one in four reported their relationship as employee (Fisher's Exact test: p = 0.002). Most caregivers (51.7%) reported being diagnosed with one or more medical condition and 89% of those diagnosed reported being prescribed medications for their illnesses. Forty-five per cent of caregivers reported that they performed one or more activity of daily living (ADL) for their care recipients daily. Conclusion: Carers of older persons in Jamaica are predominantly family members, most have not received caregiving training and most have been diagnosed with a medical condition.

RESUMEN Objetivo: Describir las características sociodemográficas y de salud, así como las necesidades implícitas de los cuidadores de las personas mayores en Jamaica. Método: Se trata de un estudio comunitario representativo a nivel nacional, en el que se entrevista una muestra de 180 cuidadores de personas de edad. Resultados: Los cuidadores tenían entre 18 y 88 años (media 50.5; s.d. = 14.7) y la mayoría (77%) eran informales en comparación con el 23% que recibían pago por el cuidado. No hubo diferencias entre los cuidadores urbanos y rurales con respecto a género, estado civil, residir con las personas objeto del cuidado, y mantener un trabajo regular a la par con la atención a los ancianos. Los cuidadores urbanos presentaban una probabilidad significativamente mayor de haber alcanzado educación secundaria en comparación con aquellos de las comunidades rurales (χ2 (2) = 7.40, p < 0.05). Más del 90% reportó no haber recibido ninguna capacitación formal en cuidados, y aquellos con ≤ 45 años eran más propensos que los de los grupos de edad ≥ 46 años a decir que deseaban recibir entrenamiento como cuidadores (χ2 (4) = 27.1, p < 0.001). Los cuidadores hombres presentaban una probabilidad significativamente mayor de ser "hijo/nieto/yerno" de personas receptoras de cuidados, que las mujeres cuidadoras, entre las cuales casi una de cada cuatro reportó su relación como empleado (Prueba exacta de Fisher: p = 0.002). La mayoría de los cuidadores (51.7%) reportaron estar diagnosticados con una o más condiciones médicas, y el 89% de los diagnosticados reportaron recibir prescripciones de medicamentos para sus enfermedades. Cuarenta y cinco por ciento de los cuidadores informó realizar una o más actividades de la vida diaria (AVD) para las personas bajo su cuidado diariamente. Conclusión: Los cuidadores de personas mayores en Jamaica son en su mayoría miembros de la familia; la mayor parte de ellos no ha recibido capacitación como cuidadores; y la mayoría han sido diagnosticados con alguna condición médica.

The Evolution of Caregiving and Attachment

Caregiving for the children seems to be one of the most challenging tasks for the parents who should devote themselves totally despite endangering them. From the evolutionary perspective, this human behavior must have been the advantage in the survival of the species and rooted in ethological origin. John Bowlby, a child psychiatrist, psychoanalyst, and great developmental researcher, had formulated the attachment theory linking psychoanalysis and ethology through evolutionary biology. His and later following researchers' outcomes have provided enormous influence on viewing parental caregiving and the insight of human relationships and interventions. This article overviews the attachment theory in terms of the goal oriented cybernetic system to gain the survival advantage of the offspring and investigates the evolutionary origin of the caregiving and attachment from the retiles of the Mesozoic era to the mammalian revolution and finally to the human being. Deeper understanding of the nurturance and adult relationships from the standpoint of evolution can provide clinical utility of awareness of clients' lives.

Analysis and strategy of family caregiving behavior in children with recurrent lower respiratory tract infection / 中国实用护理杂志

Objective To explore and analyze the influencing factors of family caregiving behavior and protective strategies in children with recurrent lower respiratory tract infection. Methods By reviewing the literature, a self-designed questionnaire for family caregiving behavior related to recurrent lower respiratory tract infection were adopted, including feeding behavior, hand hygiene, environmental factors, time of outdoor activities and family health-seeking behavior. Totally 206 cases with recurrent lower respiratory tract infection (the study group) and 206 cases with acute lower respiratory tract infection (the control group) were included and all cases were investigated by family caregiving behavior questionnaire. The influencing factors of family caregiving behavior of two groups were analyzed and compared. Results The feeding behavior in the study group was worse than that in the control group(χ2=5.14-14.76, P0.05). Conclusions We should guide parents to establish the right and reasonable family care behavior to effectively enhance children's physical fitness and disease resistance and to avoid exposure to infectious agents and harmful substances, reduce the occurrence of Recurrent Lower Respiratory Tract Infections.

Caregiving experience study of family caregivers of senile dementia patients in community / 中国实用护理杂志

Objective To get a more comprehensive view of caregiving experiences, and describe the caregiver burden and the positive aspects of caregiving of family caregivers of senile dementia patients in community and to explore the relationship between the caregiver burden and the positive aspects of caregiving. Methods Totally 80 family community-dwelling caregivers of senile dementia patients in community were investigated by Caregiver Burden Inventory (CBI) and Positive Aspects of Caregiving (PAC) questionnaires. Results The score of CBI was 54.73 ± 13.15 and the score of PAC was 28.53 ± 5.37. The score of PAC was negatively correlated with the caregiver burden (r=-0.243, P<0.05). Conclusions The caregiver burden of the family community-dwelling caregivers of dementia patients is high and the positive aspects of caregiving is at middle level. Professional help and support should be provided to the family caregivers of dementia patients by the community health service centers on the premise that the caregiving experience is fully understood. Our aim is to reduce their burden, strengthen the caregiving skills and improve the positive aspects of caregiving simultaneously.

Qualitative study on the experience and needs of caregivers of patients with hematopoietic stem cell transplantation / 中国实用护理杂志

Objective To investigate the experience and needs of caregivers of patients with hematopoietic stem cell transplantion (HSCT) , in order to provide the basis for targeted intervention. Methods Using qualitative phenomenological research methods, semi- structured interviews of 10 caregivers of HSCT patients were conducted, then the data were summarized and analyzed. Results Four themes were extracted: heavy caregiving burden, adaptation to the caregiving role, professional support needs, humanistic care needs. Conclusions The medical staff should strengthen the health education on HSCT caregivers to improve their ability and their own health concerns, alleviate their psychological pressure, and mobilize social forces to reduce the burden of care.