Vulnerability in women primary caregivers of children in palliative care due to intimate partner violence in a pediatric hospital in Mexico / Vulnerabilidad en mujeres cuidadoras primarias de menores en cuidados paliativos debida a violencia de pareja en un hospital de niños en México

Abstract Background: Women are the primary caregivers of children in palliative care. Research has shown that the presence of intimate partner violence at home exacerbates the vulnerability of the caregiver. Current statistics indicate a high prevalence of violence in Mexico present in the intersectionality between intimate partner violence and the role of the primary caregiver. This study aimed to describe the frequency of intimate partner violence among primary palliative caregivers at the Hospital Infantil de México Federico Gómez. Methods: We conducted a cross-sectional and prospective study with convenience sampling; no sample calculation was performed. All female primary caregivers of children in the palliative care unit were invited to participate. The Scale of Violence and Index of Severity of Violence was used as the measuring instrument. Results: One hundred women participated in the study by submitting their survey in a designated mailbox. No sociodemographic data or patient diagnoses were collected. The frequency of intimate partner violence was 28%, of which 16% were considered severe cases. Women reported psychological violence (36%), sexual violence (23%), and physical violence (22%). Conclusions: Almost one-third of female primary caregivers of pediatric patients at the Hospital Infantil de México Federico Gómez have been victims of some form of violence by current partners. This study highlights a previously unreported problem and opens the door for studies to correlate intimate partner violence among primary caregivers and the quality of life of children in palliative care.

Resumen Introducción: Las mujeres son las principales cuidadoras de los niños en cuidados paliativos. Las investigaciones han demostrado que la violencia de pareja en el hogar exacerba la vulnerabilidad del cuidador. Las estadísticas actuales sobre violencia en México indican una alta prevalencia presente en la interseccionalidad entre la violencia de pareja y el rol de cuidador principal. El objetivo de este estudio fue describir la frecuencia de violencia de pareja entre los cuidadores primarios del Hospital Infantil de México Federico Gómez (HIMFG). Métodos: Se llevó a cabo un estudio transversal y prospectivo con muestreo por conveniencia; no se realizó ningún cálculo de muestra. Se invitó a participar a todas las mujeres cuidadoras primarias de niños en la Unidad de Cuidados Paliativos. Se utilizó como instrumento la Escala de Violencia e Índice de Severidad de la Violencia. Resultados: Cien mujeres participaron en el estudio; no se recogieron sus datos sociodemográficos ni diagnósticos. La frecuencia de violencia de pareja fue del 28%: 16% se consideraron casos graves. Las mujeres reportaron violencia psicológica (36%), violencia sexual (23%) y violencia física (22%). Conclusiones: Alrededor de la tercera parte de las mujeres cuidadoras principales de pacientes pediátricos del HIMFG han sido víctimas de algún tipo de violencia por parte de sus parejas actuales. Este estudio destaca un problema no informado previamente y abre la puerta a estudios para correlacionar la violencia de pareja íntima entre los cuidadores primarios y la calidad de vida de los niños en cuidados paliativos.

Características de las lesiones no intencionales domésticas en niños entre 5 y 10 años que residen en barrios de Corrientes Capital, 2022 / Caracteristics of non-intencional domestic injuries in childrenbetween 5 and 10 years old who live in neighborhoods of Corrientes Capital, 2022

Objetivo: caracterizar las lesiones no intencionales domésticas en el hogar en niños de 5 a 10 años en dos barrios de Corrientes, Capital en el primer semestre del año 2022. Metodología: estudio observacional, descriptivo, transversal. Muestreo de tipo consecutivo. La muestra total fue de 185 encuestas aplicadas a los cuidadores principales en un período no mayor a 6 meses. Variables: edad del cuidador; sexo del cuidador; nivel educativo del cuidador principal; edad y sexo de niños/as; lesión no intencional y su frecuencia; circunstancias en que ocurren las lesiones no intencionales y modo de actuación ante el hecho de lesión no intencional. Resultados: grupo etario de los cuidadores principales de los niños/as con lesiones no intencionales fueron los adultos jóvenes (78%), siendo el género pre-dominante el femenino (78%); nivel de instrucción más alto obtenido corresponde al terciario incompleto (28%); los niños de 5 años de edad presentaron más lesiones no intencionales (27%), predominan-do el género femenino (57%). Las lesiones ocurrieron principalmente cuando se encontraban jugando (58%) y fueron principalmente las escoriaciones (20%); el modo de actuación más utilizado por los cuidadores principales correspondió a realización de primeros auxilios y posterior traslado al hospital (29%). Conclusiones: las lesiones no intencionales domésticas son muy frecuentes, entre ellas excoriaciones, quemaduras y contusiones. No hay grandes variaciones en sus tipos y frecuencias según el barrio en donde viven los infantes afectados. El modo de actuar más utilizado por el cuidador responsable ante estas lesiones son los primeros auxilios y el traslado a un hospital o cuidados en el hogar sin recurrir a un centro sanitario[AU]

Objectives: to characterize unintentional domestic injuries at home in children from 5 to 10 years old in two neighborhoods of Co-rrientes, Capital in the first semester of 2022. Methodology: obser-vational, descriptive, cross-sectional study. Consecutive type sam-pling. The total sample consisted of 185 surveys applied to the main caregivers in a period not exceeding 6 months. Variables: age of the caregiver; caregiver's sex; educational level of the main caregiver; age and sex of children; unintentional injury and its frequency; cir-cumstances in which unintentional injuries occur and mode of ac-tion in the event of unintentional injury. Results: age group of the main caregivers of children with unintentional injuries were young adults (78%), with the predominant gender being female (78%); highest level of education obtained corresponds to incomplete ter-tiary (28%); 5-year-old children presented more unintentional in-juries (27%), with a predominance of the female gender (57%). The injuries occurred mainly when they were playing (58%) and were mainly abrasions (20%); The mode of action most used by the main caregivers corresponded to first aid and subsequent transfer to the hospital (29%). Conclusions: unintentional domestic injuries are very frequent, including abrasions, burns and bruises. There are no great variations in its types and frequencies depending on the neighborhood where the affected infants live. The most used mode of action by the caregiver responsible for these injuries is first aid and transfer to a hospital or home care without resorting to a heal-th center[AU]

Objectivos: caracterizar as lesões domésticas não intencionais em crianças de 5 a 10 anos em dois bairros de Corrientes, Capital, no primeiro semestre de 2022. Metodologia: estudo observacional, descritivo, transversal. Amostragem de tipo consecutiva. A amos-tra total foi composta por 185 inquéritos aplicados aos cuidadores principais num período não superior a 6 meses. Variáveis: idade do cuidador; sexo do cuidador; escolaridade do cuidador principal; idade e sexo das crianças; lesão não intencional e sua frequência; circunstâncias em que ocorrem lesões não intencionais e modo de ação em caso de lesão não intencional. Resultados: a faixa etária dos principais cuidadores de crianças com lesões não intencionais eram adultos jovens (78%), com predomínio do sexo feminino (78%); o maior nível de escolaridade obtido corresponde ao ensino superior incompleto (28%); As crianças de 5 anos apresentaram mais lesões não intencionais (27%), com predominância do sexo feminino (57%). As lesões ocorreram principalmente durante o jogo (58%) e foram principalmente escoriações (20%); O modo de atuação mais utilizado pelos cuidadores principais correspondeu aos primei-ros socorros e posterior transferência para o hospital (29%). Con-clusões: lesões domésticas não intencionais são muito frequentes, incluindo escoriações, queimaduras e contusões. Não há grandes variações em seus tipos e frequências dependendo do bairro onde vivem os lactentes acometidos. A forma de atuação mais utilizada pelo cuidador responsável por estas lesões são os primeiros soco-rros e a transferência para um hospital ou cuidados domiciliários sem recorrer a um centro de saúde. caregivers corresponded to first aid and subsequent transfer to the hospital (29%). Conclusions: unintentional domestic injuries are very frequent, including abrasions, burns and bruises. There are no great variations in its types and frequencies depending on the neighborhood where the affected infants live. The most used mode of action by the caregiver responsible for these injuries is first aid and transfer to a hospital or home care without resorting to a heal-th center.Keywords: unintentional injury, infants, primary caregivers, accidents, home, housing, child, preschool[AU]

Challenges for Primary Caregivers during the COVID‑19 Pandemic in Accessing Health Care of Children with Chronic Diseases under Periodic Follow‑up at a Tertiary Care Hospital in South India

Introduction: Challenges faced by the primary caregivers during the COVID‑19 pandemic help to identify their needs and health seeking behavior during pandemic. Objectives: (1) To describe the factors associated with periodic follow‑up at the hospital which posed as difficulties to their primary caregivers during the COVID‑19 pandemic. (2) To identify the measures adopted by these primary caregivers to overcome those difficulties. MaterialsandMethods: This hospital‑based cross‑sectional observational study was conducted from May to August 2021 among 57 primary caregivers of children with chronic diseases registered before March 1, 2020, who were under periodic follow‑up in our pediatrics department. Data were collected by direct or telephonic interview using a predesigned semi‑structured questionnaire and analyzed using descriptive and inferential statistics like mean, standard deviation, proportions and paired “t”‑test using Epi info and IBM SPSS trial version 28.0. Results: Frequency of hospital visits of 14 (24.6%) subjects were reduced during the COVID pandemic compared to the prepandemic period. During the COVID pandemic, 42 (73.7%) subjects had faced transportation difficulties, 23 (40.3%) had faced financial difficulties, 22 (38.6%) had skipped their scheduled follow‑up visits and around 31.6% of them have feared of contracting COVID. None had availed telemedicine consultation for their children either before or during the pandemic. Conclusions: Difficulties faced in transportation, fear of contracting COVID, financial difficulties, and lack of awareness of teleconsultation services were identified as their major obstacles.

Study on the level of benefit finding and its influencing factors in primary caregivers of children with cerebral palsy / 中华健康管理学杂志

Objective:To explore the benefit finding and influencing factors of primary caregivers of children with cerebral palsy.Methods:This study adopted the method of random sampling, 158 primary caregivers of children with cerebral palsy in the outpatient and inpatient wards of the Children′s Rehabilitation Department of the Second Affiliated Hospital of Wenzhou Medical University from November 2020 to January 2021 were selected as the research objects. The basic data questionnaire, Chinese version of benefit finding scale, simple coping style questionnaire and perceived social support scale were used to do investigation. The influencing factors of benefit finding of main caregivers of children with cerebral palsy were investigated by single factor analysis, Pearson correlation analysis and multiple linear regression analysis.Results:The score of benefit finding of the main caregivers of children with cerebral palsy was (62.4±7.0),which was above the middle level. The years of diagnosis, the payment method of medical expenses, the place of residence and the length of caring for children had a significant impact on the benefit finding of the main caregivers of children with cerebral palsy ( F=3.45, 3.75, 3.97, 6.60, all P<0.05). The main caregivers′ sense of benefit finding was positively correlated with positive coping style, family support, friend support, others′ support and perceived social support ( r=0.43, 0.20, 0.32, 0.24, 0.30, all P<0.05), and negatively correlated with negative coping style ( r=-0.36, P<0.01).The importance of those factors influencing the benefit finding of the main caregivers of children with cerebral palsy was as follows: positive coping style, place of residence and length of caring for children (standardized regression coefficients were 0.33, 0.22, -0.32, all P<0.05). Conclusions:The main caregivers of children with cerebral palsy have a good sense of benefit finding. The main factors affecting the benefit finding of the main caregivers are the children′s residence, the length of care and coping style.

A grounded theory study of primary caregiver coping trajectories in patients with permanent enterostomy / 中国实用护理杂志

Objective:To explore the coping trajectory of primary caregivers in patients with permanent enterostomy, and to provide theoretical basis for clinical intervention.Methods:A semi-structured interview was conducted among 20 primary caregivers of patients with permanent enterostomy hospitalized in Qilu Hospital of Shandong University from May to July 2021. The data were analyzed by three-level coding and continuous comparison.Results:The coping trajectory of primary caregivers of permanent enterostomy patients experienced confusion and fatigue period, coping exploration period, acceptance and coexistence period, transformation and transcendence period.Conclusions:Medical staff should give corresponding health education and timely formulate effective intervention measures according to different stages. At the same time, we should effectively integrate external resources to promote the construction of "Hospital-Family-Community" tripartite care model to relieve the care pressure of caregivers.

Salud familiar y psicológica del cuidador primario de adultos mayores dependientes / Saúde familiar e psicológica do cuidador principal de idosos dependentes / Family and psychological health of the primary caregiver of dependent elderly

Introducción: El conocimiento de las influencias socio-familiares en los cuidadores de adultos mayores es necesario para poder ayudar a establecer el grado de funcionalidad familiar y el patrón (alteraciones) psicológico del cuidador. Objetivo: Determinar la salud familiar y psicológica del cuidador primario del adulto mayor de la Comunidad de San Vicente, Centro del Cantón Quero, provincia de Tungurahua, Ecuador en el año 2020. Método: Se realizó un estudio descriptivo y transversal en los 31 cuidadores primarios de los adultos mayores de la comunidad antes mencionada, que cumplieron los criterios de inclusión. Se aplicaron los instrumentos: cuestionario del APGAR familiar, test de Goldberg, entrevista semiestructurada con datos sociodemográficos, alteraciones psicológicas del cuidador y la escala de Zarit. Se estudiaron variables como la ansiedad, depresión, sobrecarga y funcionalidad familiar. Los datos recolectados se ingresaron a una base de datos en Excel para su análisis en el paquete estadístico SPSS 25.0. Resultados: De los cuidadores, el 83,9 porciento tuvo ansiedad, el 87,1 porciento depresión, el 35,5 porciento estuvo con sobrecarga por los cuidados y el 41,9 porciento constó con sobrecarga intensa; de las familias, se encontró que el 54,8 porciento fue disfuncional mientras que el 16,2 porciento fue disfuncional severa. Conclusiones: La mayor parte de cuidadores primarios presentan una disfuncionalidad familiar severa, con altos niveles de ansiedad y depresión, existiendo por demás una sobrecarga intensa. Al estar alterada la funcionabilidad familiar se produce desgaste del cuidador primario del adulto mayor, siendo la sobrecarga intensa y los estados de ansiedad y depresión unas de las manifestaciones psicológicas más marcadas(AU).

Introduction: Knowledge of the socio-familiar influences on caregivers of the elderly is necessary to help establish the degree of family functionality and the psychological pattern (alterations) of the caregiver. Objective: To determine the family and psychological health of the primary caregiver of the elderly in the Community of San Vicente, Centro del Cantón Quero, Tungurahua province, Ecuador, in the year 2020. Method: A descriptive and cross-sectional study was carried out in the 31 primary caregivers of the elderly who met the inclusion criteria, living in the aforementioned community. The instruments applied were: family APGAR questionnaire, Goldberg test, semi-structured interview with sociodemographic data, psychological disorders of the caregiver and the Zarit scale. Variables such as anxiety, depression, overload and family functionality were studied. The collected data were entered into an Excel database for analysis in the SPSS 25.0 statistical package. Results: 83.9 percent of the caregivers had anxiety, 87.1 percent had depression, 35.5 percent were overburdened by care and 41.9 percent had intense overload. It was found that 54.8 percent of the families were dysfunctional while 16.2 percent were severe dysfunctional. Conclusions: The majority of primary caregivers have severe family dysfunction, with high levels of anxiety and depression, and intense overload. When family functionality is altered, the primary caregiver of the elderly gets exhausted, with intense overload and states of anxiety and depression being one of the most marked psychological manifestations(AU).

Introdução: O conhecimento das influências sociofamiliares sobre os cuidadores de idosos é necessário para ajudar a estabelecer o grau de funcionalidade da família e o padrão psicológico (alterações) do cuidador. Objetivo: Determinar a saúde familiar e psicológica do cuidador principal de idosos da Comunidade de San Vicente, Centro del Cantón Quero, província de Tungurahua, Equador em 2020. Método: Estudo descritivo e transversal realizado no 31 cuidadores primários de idosos da comunidade citada, que atenderam aos critérios de inclusão. Os instrumentos foram aplicados: questionário APGAR familiar, teste de Goldberg, entrevista semiestruturada com dados sociodemográficos, transtornos psicológicos do cuidador e escala de Zarit. Variáveis como ansiedade, depressão, sobrecarga e funcionalidade familiar foram estudadas. Os dados coletados foram inseridos em banco de dados Excel para análise no pacote estatístico SPSS 25.0. Resultados: Dos cuidadores, 83,9 porcento apresentavam ansiedade, 87,1 porcento depressão, 35,5 porcento sobrecarga de cuidados e 41,9 porcento sobrecarga intensa; Das famílias, verificou-se que 54,8 porcento eram disfuncionais enquanto 16,2 porcento eram disfuncionais graves. Conclusões: A maioria dos cuidadores primários apresenta disfunção familiar grave, com altos níveis de ansiedade e depressão, e também há uma sobrecarga intensa. Quando a funcionalidade familiar é alterada, o cuidador principal do idoso se esgota, sendo a sobrecarga intensa e os estados de ansiedade e depressão uma das manifestações psicológicas mais marcantes(AU).

Carga en cuidadores informales primarios de personas adultas con enfermedades neurológicas crónicas / Burden in primary informal caregivers of adults with chronic neurological diseases

RESUMEN Introducción: Aunque el envejecimiento de las poblaciones humanas es un fenómeno universal, en Cuba los cambios demográficos son significativos. El incremento de la esperanza de vida y el desarrollo de enfermedades neurológicas crónicas aumentan el número de cuidadores informales primarios. Objetivos: Caracterizar la carga en cuidadores informales primarios de personas con enfermedades neurológicas crónicas de expresión clínica en el adulto. Método: Se trata de un estudio descriptivo, correlacional, transversal y no experimental, concebido desde una metodología mixta. La muestra quedó conformada por 19 cuidadores informales primarios con una edad aproximada de 46 años, se le aplicaron técnicas como la entrevista inicial de caracterización del cuidador y de la persona a quien cuida, la entrevista semiestructurada y la Escala de carga del cuidador de Zarit. Para el análisis de los resultados se utilizó el análisis de contenido, la triangulación metodológica y la estadística descriptiva e inferencial. Resultados: Se identificó una tendencia a percibir carga en el proceso de cuidado debido a la presencia de estresores como: el validismo disminuido del enfermo; la modificación de la actividad laboral; los años de duración de la enfermedad; las horas diarias dedicadas al cuidado; la multiplicidad de roles paralelos al de cuidador y las múltiples tareas de cuidado. Conclusiones: Se concluye, que los resultados del proceso de cuidado asociados a la carga se expresan como tendencia en: la disminución del tiempo libre de los cuidadores, el deterioro de su salud psíquica, estados emocionales negativos y un aumento de sus responsabilidades, siendo el impacto del cuidado la dimensión más significativa.

ABSTRACT Introduction: Although human population's aging is a global phenomenon, in Cuba the demographic changes are significant. The increase of the life expectancy and the development of chronic neurological diseases rise the number of primary informal caregivers. Objective: The aim of this paper was to characterize the burden in primary informal caregivers of people with chronic neurological diseases that have clinical expression in adults. Methods: Descriptive, correlational, transversal and non-experimental study that was conceived from a mixed methodology. The sample was formed of 19 primary informal caregivers with an average age of 46 years, and some techniques were used with them such as the Initial interview for characterizing the caregiver and the person they care, the semi-structured interview and the Zarit´s Burden Scale. For the analysis of the results, content analysis, methodological triangulation and descriptive and inferential statistics were used. Results: It was possible to identify a trend to perceive burden in the care process due to the presence of stressors such as: the decreased validity of the patient; the modification of work activity; the years of duration of the disease; the daily hours dedicated to care; the multiplicity of roles parallel to that of the caregiver and the multiple tasks of care. Conclusions: The results of the care process linked with the burden are expressed as a trend in: a decrease in the free time of the caregivers; a deterioration of their psychic health; negative mood and an increase of their responsibilities, being the impact of the care the most significant dimension.

Needs assessment of informal primary caregivers of patients with borderline personality disorder: psychometrics, characterization, and intervention proposal / Evaluación de las necesidades de los cuidadores primarios informales de pacientes con trastorno límite de la personalidad: psicometría, caracterización y propuesta de intervención

Abstract Introduction Informal Primary Caregivers (IPC) of people with borderline personality disorder (BPD) experience a significant burden, making it important to determine their specific needs. Objectives Cross-sectional study aimed at adapting and establishing the reliability of the Questionnaire on the Needs of Family Members of People with Severe Mental Disorders to identify felt and unfelt needs that may or may not have been met in IPCs of patients with BPD and suggest intervention strategies to effectively address them. Method The adapted version of the instrument was completed by 80 IPCs of patients with confirmed BPD diagnosis. Results Cronbach's alpha coefficients for different groups of needs evaluated through the instrument were: Knowledge/information = .77, Instrumental support = . 78, Participation = .63, and Personal support = .74; and for the total score = .86. The most important unmet felt needs were: 1. having information on interventions for patients and caregivers, legal and administrative aspects, and available support services; 2. having coping skills to deal with crises and manage patients' risk behaviors; 3. receiving professional care to reduce stress; and 4. being listened by health professionals, express their personal opinions, and need for rest. Conclusions The adapted instrument showed satisfactory internal consistency in IPCs of patients with BPD. The results highlight the urgent need for interventions for this population, focusing on psychoeducation, assertiveness training, stress management, and problem solving.

Resumen Introducción Los cuidadores primarios informales (CPI) de pacientes con trastorno límite de personalidad (TLP) soportan una pesada carga, por lo que es importante conocer sus necesidades específicas. Objetivos Estudio transversal dirigido a adaptar y determinar la confiabilidad del Cuestionario de Necesidades de Familiares de Personas con Trastornos Mentales Graves a fin de identificar las necesidades sentidas y no sentidas que han sido satisfechas o no en los CPI de pacientes con TLP y sugerir estrategias de intervención para que reciban una atención efectiva. Método Ochenta CPI de pacientes con diagnósticos confirmado de TLP completaron la versión adaptada del instrumento. Resultados Los coeficientes alpha de Cronbach para los cuatro grupos de necesidades evaluadas mediante el instrumento fueron: Conocimientos/información = .77, Apoyo instrumental = .78, Participación = .63, y Apoyo personal = .74; y para el total de la escala = .86. Las necesidades sentidas y no satisfechas que destacaron fueron: 1. tener información de intervenciones para el paciente y los cuidadores, aspectos legales y administrativos, y servicios disponibles para apoyarse; 2. contar con herramientas para afrontar crisis y manejar conductas de riesgo de los pacientes; 3. ser atendidos profesionalmente para reducir el estrés; y 4. ser escuchados por los profesionales de salud y tomados en cuenta en relación con sus opiniones personales y necesidad de descanso. Conclusiones El instrumento adaptado mostró una consistencia interna satisfactoria en CPI de pacientes con TLP. Los resultados resaltan la necesidad urgente de intervenciones para esta población, enfocadas en psicoeducación, entrenamiento asertivo, manejo del estrés ansiedad y solución de problemas.

A qualitative research on the nutritional care experience of primary caregivers in elderly patients with pressure injury in outpatients / 中国实用护理杂志

Objective@#To explore the experience of nutritional care provided by the main caregivers of elderly patients with pressure injury in outpatients.@*Methods@#Semi-structured, in-depth interviews were conducted on 15 main caregivers of elderly patients with pressure injury in outpatient by the purposive sampling method. Data was analyzed by Colaizzi content analysis.@*Results@#Seven themes were identified, including multiple troubles in nutritional care, lack of awareness of the relationship between nutrition and pressure injury, poor knowledge of nutritional care, unreliable ways to obtain the knowledge, poor attitude towards nutritional care, poor nutritional care behaviors, and differences in nutritional care needs.@*Conclusion@#Health care providers should value the evaluation of patients' eating ability and behavior, provide more learning approaches, change their attitude, improve the nutritional care behavior, and, if necessary, cooperate with nutritionists to provide targeted nutrition education, and establish effective family and social support systems.

Advance in Quality of Life of Patients with Chronic Heart Failure and Primary Caregivers (review) / 中国康复理论与实践

Chronic heart failure is the end stage of different cardiovascular diseases and usually has a high readmission rate and mortality, and the current optimal treatment is dissatisfied. The quality of life of patients with chronic heart failure and their primary caregivers is at a medium-to-low level, especially in physical, psychological and social dimensions. Furthermore, chronic heart failure patients and their primary caregivers usually suffered from a relatively higher degree of anxiety and depression, which further impaired their quality of life. The quality of life about chronic heart failure patients could be improved by using accurate drug therapy, cardiac resynchronization therapy, implantable cardioverter defibrillator and proper exercise rehabilitation according to the recent studies.

A qualitative research on the nutritional care experience of primary caregivers in elderly patients with pressure injury in outpatients / 中国实用护理杂志

Objective To explore the experience of nutritional care provided by the main caregivers of elderly patients with pressure injury in outpatients. Methods Semi-structured, in-depth interviews were conducted on 15 main caregivers of elderly patients with pressure injury in outpatient by the purposive sampling method. Data was analyzed by Colaizzi content analysis. Results Seven themes were identified, including multiple troubles in nutritional care, lack of awareness of the relationship between nutrition and pressure injury, poor knowledge of nutritional care, unreliable ways to obtain the knowledge, poor attitude towards nutritional care, poor nutritional care behaviors, and differences in nutritional care needs. Conclusion Health care providers should value the evaluation of patients'eating ability and behavior, provide more learning approaches, change their attitude, improve the nutritional care behavior, and, if necessary, cooperate with nutritionists to provide targeted nutrition education, and establish effective family and social support systems.

Assessment Of Caregiver Burden Among The Primary Caregivers Of Senior Citizen

During the 20 century the proportion of senior citizens continued to rise, and this trend is expected to continue into the 21 century. Caregiver burden refers to a high level of stress that may be experienced by people who are caring for another person with some kind of illness. Caregivers are ‘hidden patients’ and their role is stressful.The role of the primary caregiver is stressful.The primary caregivers of senior citizen who experience care giving – related stress have a 63% higher mortality rate non caregivers of the same age.it is a paramount responsibility of the nurses to assess the degree of caregiver burden among primary care givers of senior citizen and to desire coping strategies, to reduce their level of care giver burden. Objectives:Assess the level of caregiverburden among primary caregivers of senior citizen and associate the demographic variables with level of caregiver burden. Materials and Methods: Non experimental research approach of descriptive design was adopted.This study was conducted at selected rural community in Bangalore.The primary caregivers (100) of senior citizen were recruited for this study by purposive sampling technique. Zarit’s Caregiver Burden five point likert Scale (ZCBS) was used to collect the data. Findings:The over all caregiver burden is moderate to severe among 92 % of the primarycaregivers.It shows that active coping skills and management strategies are inadequate among the primary caregiver’s of senior citizens. Conclusion: assessing the degree of caregiver burden among primary care givers of senior citizen and to desire coping strategies, to reduce their level of care giver burden is an essential part for the health care providers

Ansiedad, depresión y sobrecarga en cuidadores de adultos centenarios / Anxiety, depression and work overload in centenarian adults caregivers

Introducción: La asistencia y atención de los adultos centenarios exige las funciones del cuidador principal, que, siendo miembro de la familia o no, asume la responsabilidad del cuidado. Esta actividad posee amplias repercusiones para la salud y bienestar de quien asume el rol, en tanto supone una situación de estrés que incrementa el riesgo de padecer dificultades emocionales. Objetivo: Determinar los niveles de ansiedad, depresión y sobrecarga en cuidadores principales de adultos centenarios. Métodos: Se utilizó un diseño no experimental transversal con alcance exploratorio-descriptivo. La selección de la muestra fue no probabilística o dirigida y quedó conformada por 30 cuidadores principales de adultos centenarios. Se emplearon como técnicas la entrevista, el Inventario de ansiedad rasgo-estado (IDARE), el Inventario de depresión rasgo-estado (IDERE) y la Escala de Zarit. Resultados: Se identificó en los cuidadores un predominio del género femenino en el ejercicio del rol con un rango de edad entre los 53 a 78 años. Se evidenciaron niveles medios en la ansiedad como rasgo y en la ansiedad como estado, aunque no se determinaron diferencias significativas entre los niveles altos y medios de la ansiedad como estado. Se constataron elevados niveles de depresión como estado en los cuidadores no existiendo diferencias significativas entre los niveles altos, medios y bajos de depresión como rasgo. Para la muestra de estudio no se evidencia sobrecarga en el 86,7 por ciento de los cuidadores principales en relación con el ejercicio del rol. Conclusiones: Los cuidadores principales no se perciben sobrecargados y experimentan niveles medios de ansiedad ante situaciones puntuales y generales. Los niveles de la depresión rasgo no presentan diferencias significativas, mientras que la depresión estado manifiesta niveles altos(AU)

Introduction: The care and attention of centenarian adults requires the functions of a primary caregiver, who, being a member of the family or not, assumes that responsibility. It has wide repercussions on the health and well-being of the one who assumes the caring role as well as supposes a situation of stress that increases the risk of suffering emotional difficulties. Objective: To determine levels of anxiety, depression and overload in primary caregivers of centenarian adults. Methods: A non-experimental cross-sectional design with exploratory-descriptive scope. The selection of the sample was non-probabilistic nor directed, is conformed by 30 main caregivers of centenarian adults. The main techniques applied were interviews, the trait-state anxiety inventory (IDARE), the trait-state depression inventory (IDERE) and Zarit's scale. Results: A predominance of the female gender in the exercise of the role was identified in the caregivers with a range between 53 and 78 years old. It were determined average levels of anxiety as a trait and state, although no significant differences were found between the high and medium levels of anxiety as a state. There were high levels of depression as a condition in the caregivers, but no significant differences between the high, medium and low levels of depression as a trait. In this study sample, the 86.7 percent of caregivers does not presents work overload in relation to the exercise of their role. Conclusions: Primary caregivers are not perceived as overloaded and experience average levels of anxiety in specific and general situations. The levels of the depression trait do not present significant differences whereas the depression state showed high levels(AU)

Relación entre depresión y características sociodemográficas en cuidadores principales de pacientes con enfermedad de Alzheimer / Relationship between depression and sociodemographic characteristic in principal caregivers of patients with Alzheimer's disease

RESUMEN Introducción: Las demencias constituyen unos de los problemas de salud pública más importantes del siglo XXI, la enfermedad de Alzheimer es la causa más frecuente. El mayor costo es el humano, en especial, los cuidadores principales, que contraen riesgos sobre la salud física y mental, provocándole depresión. Objetivo: Identificar la relación que existe entre la depresión y algunas características sociodemográficas de los cuidadores principales. Métodos: Estudio descriptivo correlacional en el Policlínico "Carlos Manuel Portuondo" del municipio Marianao, desde enero de 2010 hasta septiembre de 2012, en un universo de 35 cuidadores principales de pacientes con enfermedad de Alzheimer en estadios leve y moderado. La información se obtuvo con el Cuestionario sociodemográfico y clínico, e Inventario de depresión de Beck, se procesó y analizó con frecuencias absolutas y porcentaje. Se evaluó la asociación a través de la prueba paramétrica coeficiente de correlación de Pearson. Resultados: De los 35 cuidadores principales, el 82,85 por ciento pertenecían al sexo femenino; el 60,00 por ciento eran las hijas; el 45,71 por ciento tenía 60 años y más, sin vínculo laboral (85,71 por ciento), con un nivel superior de escolaridad (45,71 por ciento) y el 68,60 por ciento no recibía apoyo en el cuidado del paciente; el 37,10 por ciento mostró depresión leve. Se evidenció correlación negativa y positiva débil entre la depresión y algunas de las características sociodemográficas y clínicas del cuidador principal. Conclusión: Se identificó relación negativa y positiva débil entre la depresión y algunas características sociodemográficas de los cuidadores principales de pacientes con enfermedad de Alzheimer(AU)

ABSTRACT Introduction: Dementias are one of the issues most important public health of the century, Alzheimer's disease is the most common cause. The biggest cost is the human, especially primary caregivers, who contract risks on physical and mental health, causing depression. Objective: To identify the relationship between depression and some sociodemographic characteristics of the main caregivers. Methods: Descriptive correlational Polyclinic "Carlos Manuel Portuondo" Marianao municipality, from January 2010 to September 2012, in a universe of 35 primary caregivers of patients with Alzheimer's disease in mild and moderate. The information was obtained with the sociodemographic and clinical questionnaire, and Beck Depression Inventory, processed and analyzed with absolute and percentage frequencies. The association through parametric test Pearson correlation coefficient was evaluated. Results: Of the 35 primary caregivers the 82.85 percent were female; The 60.00 percent were daughters; 45.71 percent were 60 years and over, without employment (85.71 percent), with a higher level of education (45.71 percent) and 68.60 percent did not receive support patient care; the 37.10 percent showed mild depression. negative and weak positive correlation was found between depression and some sociodemographic and clinical characteristics of primary caregiver. Conclusion: Negative and weak positive relationship between depression and some sociodemographic of primary caregivers of patients with Alzheimer's disease characteristics were identified(AU)

Clinical values of solution- focused brief therapy for caregivers of children with type 1 diabetes / 中国实用护理杂志

Objective To investigate the effect of solution-focused brief therapy on the care burden, depression and anxiety emotions in the primary caregivers of children with type I diabetes. Methods Totally126 children with type 1 diabetes and 126 primary caregivers were randomly divided into two groups,control group(n=63 pairs)and intervention group(n=63 pairs)using random number table method.And the two groups were given conventional nursing care.For the intervention group,the primary caregivers accepted the solution-focused brief therapy.The Caregiver Burden Inventory(CBI),Self-rating Anxiety Scale(SAS),and Self-rating Depression Scale(SDS)before and after interventions were compared between the two groups. Results Before intervention,CBI,SAS and SDS were similar between the two groups (P> 0.05). After intervention: the CBI total score and five sessions, ie, time-dependent load, development-limited load, physiological load, social load, and emotional load of the intervention group were (42.78 ± 11.44), (15.74 ± 3.97), (10.76 ± 2.14), (6.85 ± 1.09), (6.15 ± 0.95), (3.28 ± 0.56), respectively,which were significantly lower than those of the control group(51.87 ± 12.20),(17.67 ± 4.76), (12.74 ± 2.58),(8.73 ± 1.13),(7.98 ± 1.26),(4.75 ± 0.75)(t=2.47-12.47,P<0.05).After intervention,the SAS (35.43 ± 9.34) and SDS (42.54 ± 10.24) were significantly reduced for the intervention group compared with the control group (46.52 ± 11.42) and (50.06 ± 12.07) (t =5.66, 4.01, P<0.05). Conclusions Solution-focused brief therapy can effectively decrease the care burden of primary caregivers of children with type 1 diabetes and alleviate their anxiety and depression emotions.

Creencias y percepciones de pacientes y familiares o cuidadores sobre el cáncer / Beliefs and perceptions about cancer patients and carers / Crenças e percepções perante o câncer em pacientes e parentes cuidadores

Objetivo. El cáncer es un fenómeno complejo, se requiere reconocer las creencias y percepciones de pacientes y familiares o cuidadores, que in-fluyen sobre las formas de pensar, decidir y actuar frente a sí mismos y al entorno. Este trabajo tiene la finalidad de ser insumo para el diseño e implementación de programas para el control del cáncer que permitan fomentar la participación y cumplimiento del tratamiento.Materiales y métodos. Se llevó a cabo un estudio cualitativo en el que participaron pacientes con cáncer y familiares o cuidadores, atendidos en el Centro de Educación del Instituto Nacional de Cancerología. Se con-formaron nueve grupos focales. Los datos se sometieron a un análisis del discurso y se utilizó el Atlas.ti, versión 7.0.Resultados. Participaron 88 personas, 39 pacientes y 49 familiares o cui-dadores, de las cuales, el 71,5 % era del sexo femenino y el 85 % era de estrato socioeconómico bajo. Se identificaron creencias y percepciones en torno a la propensión y la gravedad de la enfermedad, así como los beneficios y las barreras frente a su manejo, además de elementos clave para actuar frente a la enfermedad. Entre estos hallazgos surgen, por un lado, aspectos relacionados con la percepción de factores de riesgo y la concepción inicial del cáncer como sinónimo de muerte, y, por otro, se evidencia la existencia de distintos tipos de barreras para la obtención de un diagnóstico temprano.Conclusión. Los programas de prevención y detección temprana del cán-cer deben incluir en sus estrategias las creencias y percepciones de los individuos frente al cáncer, mejorando las estrategias de información, educación y comunicación dirigidas a la comunidad, a fin de que sean reconocidas y legitimadas para lograr mejores resultados en salud pública.

Objective: Cancer is a complex phenomenon in which beliefs and perceptions of patients and carers are key in understanding ways of thinking and acting. This study aims at providing a star-ting point for further devising and implementing programs gea-red towards increasing patient participation and compliance to cancer-related treatments.Tools and methods: A qualitative study was conducted with the participation of cancer patients and carers seeking care at the education center of a Colombian institution providing health care to cancer patients (Instituto Nacional de Cancerología). Nine focus groups were carried out; Atlas Ti version 7.0 was used for data analysis. Further analysis was implemented with the use of discourse analysisResults: This study was carried out with 88 participants; 39 pa-tients and 49 carers. 71.5% of the sample accounted for women. Sociodemographic data indicated that 85% of the participants of this study were classified as having low or medium income. Throughout the present study, beliefs and perceptions about cancer-related susceptibility, benefits and perceived barriers we-re identified. The findings of this study highlight risk factor per-ceptions and various barriers related to early diagnosis access. Conclusion: Cancer ­ related prevention and early detection programs ought to include beliefs and perceptions within their scope, when devising information, education and communica-tion strategies targeting communities, thus allowing for better outcomes in public health.

Objetivo: O câncer é um fenômeno complexo que requer con-hecimento das crenças e percepções dos próprios pacientes e seus parentes cuidadores, para entender melhor suas formas de pensar, decidir e atuar. Este artigo busca se tornar um insumo na criação e implementação de programas para o controle de câncer que facilitem a participação e aderência ao tratamento. Materiais e métodos: Estudo qualitativo com participação de pacientes com câncer e seus parentes cuidadores do Centro de Educação do Instituto Nacional de Cancerología. Foram reali-zados 9 grupos focais, sua análise foi feita com Atlas Ti versão 7.0 e a análise de dados foi feito com análise de discurso.Resultados: Participaram 88 pessoas, 39 pacientes e 49 paren-tes cuidadores, dentre eles 71,5% mulheres e 85% de baixa renda. Foram identificadas crenças e percepções em torno da susceptibilidade e gravidade da doença, mesmo como proble-mas no tratamento e diagnóstico e outros elementos chave para agir perante a doença. Conclusão: Os programas de prevenção e detecção precoce do câncer devem incluir estratégias que aprofundem as crenças e percepções dos sujeitos perante o câncer, para melhorar as es-tratégias de informação, educação e comunicação e conseguir maior legitimidade do tratamento e melhora nos impactos da saúde pública.

Clinical values of solution-focused therapy for caregivers of elderly patients with hip fractures / 中国实用护理杂志

Objective To investigate the effect of solution-focused therapy on the care burden and negative emotions of the primary caregivers with elderly patients with hip fractures. Methods One hundred and sixty-eight elderly patients with hip fractures and caregivers were divided into intervention group and control group with 84 pairs by random digits table method, and the two groups were given continual nursing care. At the same time, the primary caregivers of intervention group accepted the solution-focused therapy. Caregiver Burden Inventory (CBI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used as the evaluation indexes. Results Before intervention, the score of CBI, SAS,SDS was (42.07 ± 4.24), (50.75 ± 11.21), (51.59 ± 13.18) points in control group and (42.10 ± 3.96), (50.48 ± 12.59), (52.96 ± 13.51) points in intervention group, and there was no significant differences between two groups (P>0.05). After intervention, the score of CBI, SAS, SDS was (40.49±3.17), (50.64±11.33), (50.14±10.25) points in control group and (28.95±2.87), (36.73±9.45), (41.60±8.23) points in intervention group, and there was significant differences between two groups (t=5.42, 8.73, 7.45, all P<0.05). Conclusions Solution-focused therapy can effectively reduce the care burden of the primary caregivers of elderly patients with hip fractures and alleviate their anxiety and depression.

Investigation on knowledge,attitude and practice status quo about cardiopulmonary resuscitation in primary caregivers for patients with high risk of sudden cardiac death / 重庆医学

Objective To investigate the knowledge,attitude and practice (KAP) status quo of the primary caregivers on cardiopulmonary resuscitation (CPR) in the patients with high risk of sudden cardiac death (SCD).Methods The convenience sampling method was used to extract 139 primary caregivers of the inpatients with high risk of SCD in the cardiology department of our hospital from January to June 2015.The self-designed questionnaire was adopted to perform the KAP status quo investigation on CPR and the influence factors were analyzed.Results The scoring rate of knowledge,attitude and practice about CPR in the primary caregivers were 36.85%,64.26% and 29.24%,respectively;the cultural level,residence place,health status,training experience,first-aid experience and sick time of the patients were the influence factors of KAP on CPR (P<0.05).Conclusion The KAP status quo of CPR among primary caregivers are poor.It is necessary to strengthen CPR training in primary caregivers and improve their KAP level.

Development of a questionnaire on caregiving knowledge of primary caregivers in children with nephrotic syndrome / 中国实用护理杂志

Objective To explore an assessment questionnaire for assessing caregiving knowledge of primary caregivers in children with nephrotic syndrome. Methods Delphi method was used to review the literature. Ten primary caregivers of children with nephrotic syndrome were interviewed and five medical, nursing experts were pre-surveyed to form an expert consultation questionnaire. Sixteen experts from some provinces were selected to carry out two rounds expert consultation. To screen the dimensions, factors, entries of the questionnaire and to analyze the reliability and validity of the questionnaire. Results The positive coefficient was 100%, the expert authority coefficient was 0.95 and the expert co-ordination coefficient W test was P 65.633%. Conclusions The questionnaire of caregiving knowledge of primary caregivers of children with nephrotic syndrome developed by Delphi method has high reliability. The questionnaire is of practical significance for evaluating the care of primary caregivers of children with nephrotic syndrome.

Depresión y ansiedad en cuidadores primarios en el Instituto Nacional de Salud del Niño / Depression and anxiety in primary caregivers at Instituto Nacional de Salud del Niño

Objetivo. Determinar la presencia de depresión y ansiedad en cuidadores primarios de pacientes pediátricos. Diseño. Estudio clínico, transversal, descriptivo. Lugar. Instituto Nacional de Salud del Niño, Lima, Perú. Participantes. Cuidadores primarios de pacientes pediátricos hospitalizados. Intervenciones. Aplicación de la prueba de Goldberg para depresión, ansiedad y comorbilidad en 240 cuidadores primarios de pacientes pediátricos hospitalizados en el Instituto Nacional de Salud del Niño, entre 2014 y 2016. Resultados. El 87,5% de los cuidadores primarios presentaron síntomas de depresión y ansiedad: 13,5% ansiedad, 17% depresión y 57% comorbilidad; 12,5% no presentó trastorno alguno. Conclusiones. La frecuencia de ansiedad y depresión en cuidadores primarios de pacientes pediátricos es mayor que en la población general.

Objective: Depression and anxiety in primary caregivers of pediatric inpatients. Design: Clinical, crosssectional, descriptive study. Location: Instituto Nacional de Salud del Niño, Lima, Peru. Participants: Primary caregivers of pediatric inpatients. Interventions: Goldberg test for depression, anxiety and comorbidity was applied to 240 primary caregivers of pediatric inpatients in 2014-2016. Results: 87.5% of primary caregivers presented some type of disorder: comorbidity 57%, anxiety 13.5%, and depression 17%; 12.5% did not present any disorder. Conclusions: The frequency of anxiety and depression in primary caregivers of pediatric patients is greater than in the general population.