Autoeficacia de cuidadores informales de personas en cuidado paliativo domiciliario: Revisión narrativa / Self-efficacy of informal caregivers of people in palliative home care: A narrative review

Los cuidadores informales presentan altos niveles de estrés y sobrecarga frente al cuidado de personas a fin de vida. Sin embargo, algunos han logrado afrontar esta situación a través de su autoeficacia. OBJETIVO: El objetivo de esta revisión fue identificar los factores que influyen en el desarrollo de la autoeficacia en cuidadores informales de personas en cuidados paliativos e identificar los efectos de la autoeficacia en dichos cuidadores. MÉTODO: Se condujo una revisión narrativa de literatura científica realizada en las bases de datos Web of Science, PubMed, CUIDEN y CINAHL en base al flujograma de PRISMA, entre septiembre y octubre del 2022, por medio de los descriptores autoeficacia, cuidadores y cuidados paliativos. Los hallazgos de los artículos encontrados fueron sometidos un análisis temático por ambas autoras. RESULTADOS: Se seleccionaron 15 artículos científicos, identificando tres categorías: Factores que disminuyen el desarrollo de autoeficacia de los cuidadores informales (sentimientos de estrés, angustia y ansiedad, y sobrecarga del cuidador); Factores que favorecen el desarrollo de la autoeficacia de los cuidadores informales (esperanza, apoyo social y capacitación de los cuidadores); y los Efectos de la autoeficacia en los cuidadores informales (confianza en el cuidado otorgado, calidad de vida del receptor del cuidado, disminución del estrés y disminución de la sobrecarga del cuidador). CONCLUSIONES: A partir de los hallazgos, se concluye que el cuidador informal debe afrontar importantes retos con prontitud y de manera adecuada al brindar cuidados. Por lo que, la autoeficacia desarrollada a partir de la esperanza, el apoyo social y la capacitación, le permite mejorar la calidad de vida y bienestar tanto de sí mismo como de la persona bajo su cuidado.

Informal caregivers present high levels of stress and overload in the face of end-of-life care. However, some have managed to cope with this situation through their self-efficacy. OBJECTIVE: This study had the objective of identifying the factors that influence the development of self-efficacy in informal caregivers of people in palliative care and identify the effects of self-efficacy on these caregivers. METHOD: A narrative review of scientific literature was carried out in the databases Web of Science, PubMed, CUIDEN, and CINAHL based on the PRISMA flowchart, between September and October 2022, using the descriptors self-efficacy, caregivers, and palliative care. The findings of the articles were subjected to a thematic analysis by both authors. RESULTS: 15 scientific articles were selected, identifying three categories: Factors that decrease the development of informal caregivers' self-efficacy (feelings of stress, distress and anxiety, and caregiver overload); Factors that favour the development of informal caregivers' self-efficacy (hope, social support, and caregiver empowerment); and the Effects of self-efficacy on informal caregivers (confidence in the care given, quality of life of the care recipient, decreased stress and decreased caregiver overload). CONCLUSIONS: It was concluded that the informal caregiver must meet important challenges promptly and appropriately when providing care. Therefore, the self-efficacy developed from hope, social support, and training enables them to improve the quality of life and well-being of both them and the cared-for person.

Research progress on the assessment method of carers′ fall concern for the elderly / 中国实用护理杂志

This paper focused on the research progress of the assessment methods of carers′ fall concern for the elderly. The content of this review included the definition of carers′ fall concern, and the advantages and disadvantages of various assessment method of carers′ fall concern for the caregivers to the elderly, such as qualitative interviews, questionnaires, and scales. Through this review, the authors hoped to provide a reference for selecting or developing a localized carers′ fall concern assessment tool.

Carers' concern for older people falling at home: an integrative review

Falls, the leading cause of injury and death among older people, can have a significant psychosocial impact on carers. Carers play a crucial role in caring for older persons at home and in fall prevention. This review, which included 15 studies, aimed to identify carers' concern about older people falling and its impact. We identified that most carers had concerns about repeated falls in older people, unknown consequences of falls and care recipients' non-adherence to fall prevention advice. These concerns, in turn, affect carers' physical and psychological health, lifestyle, caregiving burden and use of fall prevention strategies. This paper highlights the importance of recognising carers' fall concern so as to identify carers' needs and awareness of fall prevention in older people living at home. Greater insight into carers' fall concern could facilitate the implementation of new strategies to manage older people's fall risk as well as improve carers' well-being.

Competencias para el cuidado en el hogar del paciente y el cuidador en un programa de diálisis peritoneal / Level of competence for home care of the patient and carer in a program of peritoneal dialysis

Objetivo: describir competencias para cuidado en hogar del paciente y cuidador de un programa de diálisis peritoneal de una institución de salud de Sincelejo. Método: abordaje cuantitativo descriptivo de corte transversal. Muestra de 32 pacientes y 32 cuidadores vinculados al programa, donde reciben terapia dialítica. Instrumento utilizado: encuesta de caracterización del paciente y cuidador con enfermedad crónica y competencia para el cuidado en el hogar de persona con enfermedad crónica/cuidador familiar versión larga. Para el análisis se utilizó estadística descriptiva, procesamiento de datos en programa Excel 2016 y SSPS versión 23. Resultados las características para cuidador y paciente muestran nivel de escolaridad bajo medio; nivel socioeconómico bajo medio; la mayoría son casados, se ocupan en actividades del hogar. Los diagnósticos más frecuentes son: diabetes, hipertensión e hipertensión más diabetes. El 56% de pacientes percibe que no es carga para su familia, percepción baja; el 21,9% media y 12,5% alta. Utilizan TICs como medio de distracción, sobre todo la televisión. En cuanto a las competencias de pacientes y cuidadores, su nivel es similar en dimensiones de conocimiento, unicidad, instrumental, anticipación, relación e interacción; la más alta es el disfrute. Conclusión: el nivel de competencia para el cuidado en el hogar del paciente y el cuidador es alto, esto permite inferir que las intervenciones en el programa de diálisis peritoneal se han consolidado y favorecen el desarrollo de habilidades para asegurar un cuidado continuo a través de la educación temprana. Palabras claves: Enfermedad renal crónica, diálisis peritoneal, pacientes, cuidadores, competencias para el cuidado en el hogar.

Objective: to describe competences for home care of patient and carer in a program of peritoneal dialysis of a health institution in Sincelejo. Method: descriptive quantitative approach of transverse cut. Sample of 32 patients y 32 carers involved in the program, where they receive dialytic therapy. Resource used: characterization survey of patient and carer with chronical illness and competence for home care of person with chronical illness/family carer long version. For this analysis it was used descriptive statistics, data processing in programs Excel 2016 and SSPS version 23. Results: the characteristics for carer and patient show a school level low medium; socioeconomic level low medium; the majority are married; they spend time in household activities. The more frequent diagnoses are diabetes, hypertension, and hypertension and diabetes. 56% of the patients perceive that they are not a burden for their families, low perception; 21,9% medium and 12,5% high. They use TICs as distractors, especially television. About competences of patients and carers, their level is similar in knowledge dimensions, uniqueness, instruments, anticipation, relation and interaction; the higher one is joy. Conclusion: the level of competence for home care of the patient and carer is high, this allows to infer that interventions in the program of peritoneal dialysis have strengthen in favor of development of abilities to ensure continuous care through early education. Key words: chronic renal illness, peritoneal dialysis, patients, carers, competences for home care.

Common mental disorder among family carers of demented older people in Brazil / Transtorno mental comum em familiares cuidadores de idosos com demência no Brasil

ABSTRACT - Objective: Population aging is a global phenomenon associated with a rising prevalence of chronic degenerative diseases such as dementia. Dementia poses a challenge not only for patients but also their family caregivers who, in exercising this role, are at higher risk of mental illness. The present study investigated the prevalence of common mental disorders (CMD) in family caregivers of demented elderly seen at a geriatric outpatient clinic of a Brazilian teaching hospital. Methods: A cross-sectional study was conducted in which the following assessment instruments were applied: the Self Reporting Questionnaire, Zarit Burden Interview, Hospital Anxiety and Depression Scale and Mini-Mental State Examination (caregivers aged ≥65 years) plus a sociodemographic questionnaire. Results: The sample comprised 90 caregivers; 83 (92.2%) women, 51 (56.7%) married, 60 (66.7%) son/daughter of elder and 62 (68.6%) holding another job besides caring for the demented elder. Caregivers had a mean age of 57.3 (±11.7) years and mean education of 9.5 (±4.9) years; 62.2% of caregivers were diagnosed with common mental disorder, 50% exhibited anxiety symptoms, 52.2% depression symptoms and 66.7% reported burden. Caregivers with common mental disorder had higher scores on the anxiety, depression and burden scales (p<0.01). Logistic regression showed that caregivers with anxiety symptoms were 15 times more likely to present common mental disorder (OR: 15.0; 95% CI: 3.5-71.2) and caregivers with symptoms of depression were 8 times more likely to have CMD (OR: 8.0; 95% CI: 2.1-31.1). Conclusion: Results revealed a high prevalence of common mental disorder in the population studied.

RESUMO - Objetivo: O envelhecimento populacional é um fenômeno mundial que está associado ao aumento da prevalência de doenças crônico-degenerativas, como as demências. Demências desafiam não somente os pacientes, mas também seus familiares cuidadores que, como consequência, estão em maior risco de adoecimento mental. O estudo verificou a prevalência de transtorno mental comum em familiares cuidadores de idosos com demência acompanhados em ambulatórios de geriatria de um hospital-escola brasileiro. Métodos: Neste estudo transversal, os instrumentos de avaliação utilizados foram: Self Reporting Questionnaire, Zarit Burden Interview, Hospital Anxiety and Depression Scale e Mini-Exame do Estado Mental (cuidadores com 65 anos ou mais) e questionário sócio demográfico. Resultados: A amostra foi composta por 90 cuidadores; 83 (92,2%) era do sexo feminino, 51 (56,7%) casados, 60 (66,7%) filhos(as) do idoso e 62 (68,6%) possuíam alguma ocupação além de cuidar do idoso dementado. A média de idade foi 57,3 (±11,7) anos e a média de escolaridade foi de 9,5 (±4,9) anos; 62,2% dos cuidadores apresentaram transtorno mental comum, 50% apresentaram sintomas de ansiedade, 52,2% apresentaram sintomas de depressão e 66,7% apresentaram sobrecarga. Cuidadores com transtorno mental comum apresentaram escores maiores nos instrumentos de ansiedade, depressão e sobrecarga (p<0,01). Regressão logística mostrou que cuidadores com sintomas de ansiedade tiveram 15 vezes mais chances de apresentar TMC (OR: 15,0; IC95%: 3,5-71,2) e cuidadores com sintomas de depressão tiveram 8 vezes mais chances de apresentar TMC (OR: 8,0; IC95%: 2,1-31,1). Conclusão: Resultados encontrados demonstram que, na população estudada, existe alta prevalência de transtorno mental comum.

Association between depressive syndrome and visual complaints among elderly caregivers / Associação entre síndrome depressiva e queixas visuais em idosos cuidadores

ABSTRACT Objectives To determine depressive syndrome in community-dwelling elderly caregivers; and to test the association between such syndrome and both visual complaints (VC) and aspects of care. Methods This is a cross-sectional study conducted with 332 elderly caregivers. Geriatric Depression Scale (GDS-15) was used to screen for depressive symptoms (cutoff > 5 points). Logistic regression was performed to identify associations between depression and both VC and aspects related to care. Results Median age of the caregivers was 68 years. The majority was female (75.9%) and took care of a spouse (84.3%). The prevalence of depressive syndrome was 22.6%. The syndrome was associated with VC when it affected activities of daily living (OR = 2.4; 95% CI: 1.37-4.27) and caring for an individual with cognitive impairment (OR = 1.85; 95% CI: 1.05-3.26). Conclusions While measured aspects of care did not exert an influence on the incidence of depressive symptoms, VC associated to functional limitation and caring for elderly individuals with cognitive impairment was associated with such symptoms in the elderly caregivers.

RESUMO Objetivos Determinar a síndrome depressiva em idosos cuidadores da comunidade e testar a associação entre tal síndrome, queixas visuais e aspectos dos cuidados. Métodos Este é um estudo transversal realizado com 332 idosos cuidadores. A Escala de Depressão Geriátrica (GDS-15) foi utilizada para triagem da síndrome depressiva (corte > 5 pontos). Regressão logística foi realizada para identificar associações entre depressão, queixas visuais e aspectos relacionados ao cuidado. Resultados A mediana de idade dos cuidadores foi de 68 anos. A maioria era do sexo feminino (75,9%) e estava cuidando do seu cônjuge (84,3%). A prevalência da síndrome depressiva foi de 22,6%. A síndrome foi associada com queixas visuais quando estas prejudicavam o desempenho nas atividades da vida diária do cuidador (OR = 2,4; IC 95%: 1,37-4,27). Além disso, cuidar de um indivíduo com comprometimento cognitivo também esteve associado à depressão nos cuidadores (OR = 1,85; IC 95%: 1,05-3,26). Conclusões Os aspectos do cuidado não exerceram influência sobre a incidência de síndrome depressiva, no entanto a queixa visual associada à limitação funcional e o ato de cuidar de idosos com comprometimento cognitivo estiveram associados ao humor deprimido em idosos cuidadores da comunidade.

Fall concern about older persons shifts to carers as changing health policy focuses on family, home-based care

With the Singaporean population ageing at an exponential rate, home carers are increasingly becoming essential partners in fall prevention and care delivery for older persons living at home and in the community. Singapore, like other Asian countries, regards the family as the main support structure for the older person, and national policies have been implemented to support this cultural expectation. Family carers experience similar concerns as older persons with regard to fall risk, and identifying and addressing these concerns can potentially lower fall risk and improve fall prevention for older persons. It is timely to remind ourselves - as concern about falls in older persons begins to shift to carers - to incorporate the influence of Asian cultural values and unique family dynamics of outsourcing family caregiving, in the management of older persons' fall risk in the community.

The Feasibility, Awareness, Knowledge And Attitudes Towards Animated Epilepsy Educational Video (Aneev) Among Family Caregivers

The educational needs of epilepsy family caregivers vary depending on their relationship to the patients, their role in providing care and their emotional needs. Carers often have lack of confidence in their ability to seek information, resulting in barriers to receive information. Various educational programmes / materials about epilepsy were designed to improve the awareness, knowledge and attitudes (AKA) of patients and their families. Therefore, this study aimed to assess the feasibility, acceptability and practicality of Animated Epilepsy Educational Video (AnEEV) and AKA of family caregivers (FCGs). This part of a randomized, controlled study included a sample of 32 epilepsy FCGs who were recruited from the Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. Descriptive statistics were employed for data analyses (SPSS 17.0). Most were women (59.46%), married (65.6%), earning between RM1001 - RM2000 (34.4%), receiving secondary level education (65.6%) and were patients’ parents (65.6%). The AnEEV was highly acceptable (97.0%), easy to understand (90.9%), attractive (93.9%) and useful (87.9%). Almost all carers recommended AnEEV to other carers (97.0%) and were hoping to receive such educational materials in the future (93.9%). The Total AKA score was generally good (median=125.0; range=75.0-155.0) with awareness being moderate (median=30.0; range=0.0-50.0), knowledge was good (median=60.0; range=40.0-75.0) and attitudes were positive (median=35.0; range=10.0-40.0). The overall outcomes signified that AnEEV were well-received by the family caregivers and these favourable findings suggested that AnEEV could help in improving AKA for carers, which could ultimately assist epilepsy treatment, management and rehabilitation process

Habilidad de cuidado y carga de cuidadores familiares de personas con enfermedad crónica / Ability to care and burden of family caregivers of people with chronic illness

Introducción: Las enfermedades crónicas no trasmisibles (ECNT) representan en el sustento epidemiológico según la OMS, un significativo incremento con altos índices de prevalencia siendo las enfermedades cardiovasculares, el cáncer, las enfermedades respiratorias crónicas y la diabetes ­ las responsables del 63% de las muertes que se producen en el mundo (36 millones de 57 millones de muertes globales). El 80% de estas muertes se dan en los países de ingresos bajos y medios. Más de 9 millones de las muertes se producen en personas menores de 60 años. Objetivo: Determinar la relación que existe entre la habilidad de cuidado y la carga de los cuidadores familiares de pacientes con enfermedad crónica no transmisible. Método: Estudio de tipo cuantitativo correlacional con una intervención en un grupo de cuidadores, que busca medir la relación que existe entre la habilidad de cuidado y la percepción de carga del cuidado en los cuidadores de personas con enfermedad crónica. Participaron 70 cuidadores pertenecientes a ASCVIDA. Instrumentos utilizados: GCPC-UN-D Este instrumento se define como ficha de caracterización de la diada cuidador ­ persona con enfermedad crónica, se identifican las necesidades básicas de información para cuidar a una Diada a través de tres dimensiones: 1) Identificación de condiciones del cuidador y su perfil sociodemográfico. 2) La percepción de carga y apoyo. 3) Los medios de información y comunicación. Escala para medir la habilidad de cuidado de los cuidadores familiares de personas con enfermedad crónica. (Barrera Lucy, 2008) el cual contiene 3 dimensiones: a) Relación; b) Comprensión; c) Modificación de la vida y Escala de valoración ZARIR. El análisis estadístico de relación se realizó mediante la determinación de los coeficientes de correlación de Spearman. Resultado: Las características socio demográficas de los cuidadores de personas con ECNT son: La mayoría son mujeres de 50 años, estado civil casados, estrato socioeconómico 1 y 2, nivel educativo igual proporción primaria y bachillerato, ocupación hogar. Al valorar el nivel de carga se evidenció una carga leve en 33 de los 70 cuidadores, representando el (47%). Al medir la habilidad se encontró una significancia en la dimensión de compresión. Cuando se relacionó la carga y la habilidad se encontró una puntuación de 0.262. Si contribuyen de manera modesta. Conclusiones: Al establecer la relación entre la carga y la habilidad de cuidado de los cuidadores de personas con ECNT, se acepta la hipótesis de relación que señala que existe relación en el nivel de habilidad en sus categorías de cuidadores familiares de personas en situación de enfermedad crónica y el nivel percibido de carga.

Introduction: Chronic Noncommunicable diseases (NCDs) represent in the epidemiological support according to WHO, a significant increase with high prevalence rates being cardiovascular diseases, cancer , chronic respiratory diseases and diabetes - are responsible for 63% of deaths produced in the world ( 36 million of 57 million global deaths). 80 % of these deaths occur in low- and middleincome. More than 9 million deaths occur in people under 60 years. Method: To determine the relationship between the ability to care and burden of family caregivers of patients with chronic non-communicable disease. Results: Demographic partner caregivers of people with NCDs characteristics are: Most are women in their 50s, married marital status, socioeconomic stratum 1 and 2, primary education level equal proportion and high school, home occupation. In assessing the charge level showed a slight load in 33 of the 70 caregivers, representing (47%). By measuring the ability a significance in the dimension of compression found. When the load and the ability of a score related found 026. If they contribute modestly. Conclusions: In establishing the relationship between the load and the ability to care for caregivers of people with NCDs, we hypothesized relationship indicates that there is a relationship in the skill level in the categories of family caregivers in chronic illness is accepted and the perceived level of charge

Acolhimento familiar em Portugal e Espanha: uma investigação comparada sobre a satisfação dos acolhedores / Family foster care in Portugal and Spain: a comparative research on the satisfaction of foster carers

ResumoEste estudo apresenta uma comparação entre as experiências de famílias de acolhimento de Portugal e Espanha, avaliando-se a sua satisfação com a informação recebida antes do acolhimento; a preparação da criança para o acolhimento; os apoios técnico e financeiro; e a evolução do processo de acolhimento. Pretende-se contribuir para melhorar e promover a medida de acolhimento familiar nos dois países. Os processos de acolhimento familiar dependem de fatores históricos e culturais que produzem diferenças importantes nos diversos contextos internacionais. Assim, foram realizadas entrevistas em duas amostras aleatórias constituídas por 52 famílias de acolhimento em Portugal e 46 na Espanha, cujos resultados foram comparados através de testes estatísticos paramétricos e não paramétricos. Os acolhedores, em ambos os países, mostraram um elevado grau de satisfação com o processo de acolhimento. No entanto, em Portugal, existe maior preocupação com o fraco apoio financeiro, as informações não fornecidas pelos serviços de acolhimento ou a má preparação da criança para o acolhimento. Por fim, são apresentadas sugestões para a melhoria da gestão e implementação desta resposta social. (AU)

AbstractThis study provides a comparison between experiences of Portuguese and Spanish foster families and evaluates their satisfaction with the information received before the host; the preparation of the child for the foster care; the technical and financial support; and the evolution of the foster care process. It aims to contribute to improving implementation and development of this social response in both countries. The foster care processes depend on historical and cultural factors that have significant differences in various international contexts. Thus, two random samples of 52 foster families in Portugal and 46 in Spain were interviewed, and the results were compared using parametric and non parametric statistical tests. The carers, in both countries, show a high degree of satisfaction with the foster care process. However, in Portugal there is greater concern about the poor financial support, information not provided by the foster care services or poor preparation of the child for childcare. Finally, the study presents suggestions for improving the management and implementation of this social response. (AU)

Experiências de ser um ex-jovem cuidador: efeitos na transição para a idade adulta e na atual situação de vida / Experiences of being a former young carer: effects in the transition into adulthood and in the present life situation

Este estudo qualitativo tem por objetivo descrever experiências de adultos com responsabilidade de prestação de cuidados durante a infância. Dezesseis entrevistas semiestruturadas com ex-jovens cuidadores foram realizadas e analisadas utilizando procedimentos de codificação aberta e axial e técnicas de comparação constante. Ser responsável enquanto criança, em termos de prestação de cuidados, tem um impacto sobre todos os envolvidos. Ao entrar na idade adulta, a maioria dos ex-jovens cuidadores mantem a responsabilidade para com a pessoa doente. Sentem-se divididos entre o esforço de tentar organizar sua vida de uma nova forma e aferrar-se a uma vida em que a responsabilidade é ainda uma preocupação dominante. Eles permanecem em silêncio sobre a prestação de cuidados devido ao receio de memórias dolorosas ou pela incapacidade de reconhecer-se como ex-jovens cuidadores. O conhecimento da situação de ex-jovens cuidadores permite melhorar a compreensão de como a prestação de cuidados molda a transição para a vida adulta e pode ajudar a evitar um papel de cuidador inadequado para atuais crianças prestadoras de cuidados.

This qualitative study aims to describe the experiences of adults with caring responsibilities during their childhood. 16 semi-structured interviews with former young carers were conducted and analyzed using open and axial coding procedures and constant comparison techniques. Being responsible as a child in terms of caregiving has an impact on every person concerned. When entering adulthood, most former young carers maintain the responsibility for the ill person. They feel torn between the effort of trying to arrange their life in a different way and holding on to a life where responsibility is still a dominant concern. They remain silent about caregiving due to the fear of painful memories, or the inability to recognize themselves as former young carers. Knowledge of former young carers' situation can improve the understanding of how caring shapes the transition into adulthood and can help to prevent an inappropriate caring role of actual caregiving children.

Relações familiares de cuidadores de pessoas com deficiência intelectual profunda / Family relations of carers of profound intellectually disabled people

O objetivo desta pesquisa foi estudar as relações familiares no cuidado a pessoas com transtornos crônicos. Participaram desta pesquisa cinco famílias, responsáveis pelo cuidado de pessoas dependentes, com deficiência intelectual profunda, que responderam à escala de Crichton e a uma adaptação do APGAR Familiar (Smilkstein). Os resultados mostraram que as famílias encontram-se integradas na relação de ajuda, participação de seus membros na tomada de decisões, liberdade dos seus membros nas questões financeiras, relação afetiva positiva e tempo que dedicam ao paciente crônico. Nestes casos estudados, a interação familiar não sofreu prejuízo devido à dependência crônica de alguns de seus membros.(AU)

The aim of this research was to study changes in family relations dues to caring of chronic disabled people. Five families responsible for caring of dependent profound intellectually disabled people participated in this research, answering to the Crichton Scale and to the adapted version of the Family APGAR (Smilkstein). Results showed that families are integrated regarding support, family members’ participation in decision making, freedom in financial issues, positive affective relations and time dedicated to the chronic patient. In the cases studied family interaction has not been disturbed by the chronic dependence of some of its members.(AU)

Analysis on influencing factors for carer burdens from hospitalized pa-tients with hip fractures and the effects of cognitive behaviour interven-tion / 中国现代医生

Objective To explore the influencing factors for carer burdens from hospitalized patients with hip fractures and the effects of cognitive behaviour intervention. Methods A total of 120 key carers of 120 hospitalized patients with hip fractures were selected, and CBI, SAS and SDS were applied to carried out baseline investigation for carers. Influ-encing factors for carer burdens were analyzed, and they were afterwards randomly assigned to an intervention group and a control group with 60 patients in each. The intervention group was given cognitive behaviour intervention. CBI, SAS and SDS were compared between the two groups. Results Educational level, relation with the patients, common caregivers, caring time, household family income and patients' self-care ability were correlated with carer burdens (P<0.05), in which common caregivers, caring time and patients' self-care ability were independent influencing factors for carer burdens (P<0.05). After intervention, development limitation burdens, social burdens, emotional burdens and total burdens were all significantly lower than those in the control group (P<0.05), and SAS and SDS scores were signifi-cantly lower than those in the control group (P<0.05). CBI score was positively correlated with SAS and SDS scores (r=0.398, 0.318, P<0.05). Conclusion During caring period for carers for hospitalized patients with hip fractures, intensity, time, patients independence degree and anxiety and depression degrees are closely correlated with their burdens, and cognitive behaviour intervention is able to effectively improve carers' burdens and psychological states.

Validación de una escala para medir la habilidad de cuidado de cuidadores / Validation of a scale to measure the ability to care for caregivers

La presente investigación se enmarca dentro de la línea de investigación de Habilidad de Cuidado, del Grupo de investigación Cuidado al Paciente Crónico y su familia de la Facultad de Enfermería de la Universidad Nacional de Colombia; busca determinar la validez facial y de contenido de una propuesta de modificación semántica de la escala para medir habilidad de cuidado de cuidadores familiares de personas con enfermedad crónica diseñada por Barrera. El diseño del estudio se es de tipo metodológico con abordaje cuantitativo que realizó en tres fases Adecuación semántica, determinación del grado de comprensibilidad y Validez Facial y de contenido de la propuesta de modificación de la escala. Para determinar el grado de comprensibilidad se aplicaron 385 formatos diseñados por la investigadora, a una población con diferentes niveles educativos y socioeconómicos, mayores de 18 años, encontrando cinco ítems con comprensibilidad baja y diez ítems con comprensibilidad media, los cuales fueron examinados semánticamente y recibieron cambios a la luz de la teoría y de las observaciones de los sujetos. La validez facial y de contenido se estableció mediante el método de panel de expertos, las pruebas estadísticas en esta fase se desarrollaron con el índice de concordancia de Kappa de Fleiss; la validez facial, fue determinada mediante la evaluación de los ítems en las categorías de comprensión y claridad, encontrando que la mayoría de los ítems fueron aceptados tanto por la población que determinó la comprensión como por los jueces que evaluaron la claridad, concluyendo que la escala diseñada por Barrera y modificada semánticamente en el presente estudio, cuenta con validez facial puesto que de acuerdo a los resultados obtenidos mide lo que pretende medir. En la validez de contenido se evaluó suficiencia, coherencia, relevancia y esencialidad, encontrando que el contenido de la escala construida es válido para medir la habilidad de cuidado de cuidadores familiares de personas con enfermedad crónica, sin embargo, es importante revisar los ítems, que no alcanzaron los valores aceptables para el presente estudio, con el fin de propender por ítems más pertinentes y adecuados para medir dicho constructo.

This study is in the context of the research strand corresponding to Care Skills held by the investigation team Care to Chronic Patients and their families from the nursing department at Universidad Nacional de Colombia. Its aim is to determine the facial and contents validity of a proposal of semantic modification of the scale to measure care skill in relatives caregivers of people with chronic ills designed by Barrera. This methodological study with a quantitative approach was developed in three phases: Semantic Modification, Comprehension degree, and facial and contents validity of the modification of the scale. To determine the comprehension degree, 385 forms designed by the researcher were applied to a group of people, older than 18, from different educational and social-economic backgrounds. Five items with low Comprehension and ten items with average comprehension were found and semantically examined. Those items were changed in light of the theory and the individuals' remarks. Facial and contents validity was established through the experts panel method; in this phase, the statistics tests were developed by means of the Correspondence Rate by Kappa de Fleiss. Facial validity was determined by the evaluation of the items regarding comprehension and clarity; it was found that most of the items were accepted by both the population who defined the comprehension and the judges who evaluated clarity. In conclusion, the scale designed by Barrera, and semantically modified in this study, has facial validity since, according to the results, it measures what it is expected to measure. In regards to contents validity, proficiency, coherence, relevance and importance were evaluated to come up with the conclusion that the content´s scale is valid for to measure care skill in relatives caregivers of people with chronic ills, however, is important to check the items that did not reach them the acceptable values for this study, with the purpose to have items more relevant and appropriate to measure this construct.

Condiciones sociolaborales como base para la gestión del cuidado en unidades de alta complejidad / Sociolaboral conditions as the base for care management in high complexity units

Se realizó estudio cuasiexperimental con el objetivo de evaluar las condiciones sociolaborales, como base para la gestión del cuidado de los cuidadores formales en unidades de alta complejidad de la provincia de Camagüey, Cuba, de enero del 2007 hasta enero del 2009. La muestra quedó conformada por 257 profesionales de la enfermería que laboran en los servicios de atención al grave. El estudio constó de 3 fases: Fase I: identificación del problema (aplicando guía de observación y cuestionario), para lo cual se confeccionó un formulario como base de datos para las variables categoría profesional, servicio donde laboran, sexo, horario de trabajo, condiciones de trabajo, ambiente de trabajo, tarea de cuidar, evaluación del desempeño profesional, evaluación de estrategias de intervención. Se aplicó la Fase II mediante un plan de acción, con 3 categorías: condiciones de trabajo, ambiente de trabajo, tarea de cuidar. La Fase III fue de Evaluación, basado en los indicadores de medidas propuestos. Los datos se precesaron mediante el paquete estadístico Spss versión 11,0. Se describieron los elementos antes y después de la aplicación de las estrategias según ambiente de trabajo y tarea de cuidar. Al analizar la evaluación en el desempeño profesional, 254 plantearon satisfacción en su desempeño después de las estrategias (98,83 por ciento), con lo que se pudo demostrar que el mejoramiento de las condiciones sociolaborales en unidades de alta complejidad, constituye una de las bases fundamentales para la gestión del cuidado en el mantenimiento de la salud de los profesionales de la enfermería(AU)

A quasi-experimental study was conducted to assess the sociolaboral conditions, as the base for care management of formal carers in units with a high complexity in the Camagüey province, Cuba from January, 2007 to January, 2008. Sample included 257 nursing professionals working in the services of severely ill care. Study had three phases: Phase I: problem identification (applying the observation guide and questionnaire) creating a form as the database for the variables of professional category, work environment, care task. The Phase II was the Assessment, based in the proposed measures indicators. Data were processed by means of the Spss version 11,0 statistic package. Elements were described before and after implementation of strategies according to work environment and care task. Analyzing the professional performance assessment, 254 proposed to have satisfaction in its performance after strategies (98,83 percent) demonstrating that the improvement of sociolaboral conditions in units with a high complexity, is one of the essential bases for care management in the health maintenance of the nursing professionals(AU)

Experiencia de cuidar a un paciente con enfermedad crónica después de recibir una capacitación / Experience of caring for a patient with chronic disease after receiving training

Objetivo: El propósito de esta investigación es describir la experiencia de ser cuidador de una persona en situación de enfermedad crónica después de recibir una capacitación. Metodología: El tipo de diseño fue cualitativo, tipo teoría fundamentada, a fin de enriquecer y fortalecer el cuidado de enfermería a partir de la comprensión de la realidad de la persona. La saturación teórica de la información se llevó a cabo después de realizar entrevistas a profundad a 11 informantes. Resultados y Discusión: Durante el proceso de análisis de la información se tuvo en cuenta varias etapas, como la identificación de códigos, la conceptualización de las categorías derivadas de los mismos, la identificación de la variable central, para finalmente realizar la validaron de los resultados obtenidos entre los participantes y el asesor externo. Conclusiones: El desarrollo de estos pasos permitió identificar que la experiencia de cuidado se vive en tres fases que se relacionan entre sí y hacen referencia al proceso desarrollado por el cuidador durante su participación en el programa; este proceso se inicia con una exploración y contacto, continúa con una situación de comprensión y progreso, para finalmente experimentar cambios y nuevos retos que emprender.

Objective: The purpose of this research is to describe the experience of being a caregiver of a person in a situation of chronic disease after receiving training. Methodology: The type of design was qualitative grounded theory type, in order to enrich and strengthen the nursing care from understanding the reality of the person. Theoretical saturation of information was carried out after performing depth interviews with 11 informants. Result and Discussion: During the process of data analysis took into account several stages as the identification code, the conceptualization of categories derived from them, the identification of the central variable to finally make the results validated between participants and the external consultant. Conclusion: The development of these steps allowed us to identify the care experience is lived in three phases which are interrelated and refer to the process developed by the caregiver while participating in the program, this process begins with an exploration and contact, a situation of understanding and progress to finally undergo change and new challenges to undertake.

Esquizofrenia: dando voz à mãe cuidadora / Schizophrenia: listening to carer mothers

Objetivou-se investigar as repercussões desencadeadas na vida de mães cuidadoras ao longo do curso do transtorno esquizofrênico de seus filhos. Doze participantes responderam a uma entrevista semiestruturada e suas narrativas foram examinadas por meio da análise de conteúdo temática. Foram encontrados sete eixos temáticos, cada qual apontando momentos, problemáticas e correlatos emocionais específicos: estranhamento, o estigma da loucura, a chegada ao consultório médico, o diagnóstico, resistindo ao tratamento médico, mudanças na vida, aceitação ou resignação. Os resultados evidenciaram a natureza invasiva do transtorno mental na vida da mãe cuidadora, a especificidade das sobrecargas vivenciadas em cada período do curso da esquizofrenia e a dificuldade encontrada na elaboração psíquica da condição do filho, mesmo após muitos anos do diagnóstico.

This paper aims to investigate the impact on the lives of carer mothers of a son or daughter with a schizophrenic disorder. Twelve participants were questioned in a semi-structured interview, and their stories were reviewed by means of an analysis of the thematic content. The data showed seven themes relating to different moments, each one with specific demands and emotional responses: alienation; the stigma of mental disorder; seeking psychiatric help; diagnosis; resisting medical treatment; life changes; acceptance or resignation. The findings showed the following: Living with a chronic mental disorder, for the participants of this study, was associated with a severe disruption in their lives; the burden of care was different at different moments of the course of the schizophrenia; the emotional acceptance of the son's or daughter's situation was very hard, even many years after diagnosis.

Carers As Teachers

Objectives: This paper reports the outcome of Session With Carer, one of the activities in the Year 4 Personal and Professional Development (PPD) module in the new integrated curriculum of the Undergraduate Medical Programme at the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM). Methods: This activity involves groups of 14 – 15 students sitting in with family members of individuals with mental illness. The session starts with the carer giving his or her perspective of patient’s care and the challenges involved. This is followed by a question and answer session. Finally, the carer provides a written feedback by way of scoring certain items as well as brief comments. After the session, each student is required to prepare an individual report in the form of reflective writing. Results: Out of a total of 224 students, the reflections of 126 students were reviewed to assess what they had learnt from the Session With Carer. Among the more significant findings were: 100% learnt about the various challenges faced by carers. 31.7% learnt the importance of faith/spirituality of the carer in caring for a mentally ill family member. 29.4% learnt the importance of family and others’ support. An equal number, that is, 26.2% learnt that it helps for the carer to have good mental health and a positive attitude, as well as good knowledge of the illness. Those who became aware of the benefits of the carer having patience and determination made up 23.8% of the total reflections reviewed. Conclusion: The findings show that the Session With Carer is very educational, and helps create more awareness of the importance of the carer’s role in patient management and support. In other words, carers can act as teachers in creating more public awareness about mental illness and ultimately, help in gradually removing the stigma associated with mental illness. Therefore, carers should be utilized for this purpose.