Spouse Caregivers' Experiences of Suffering in Relation to Care for a Partner With Brain Tumor: A Qualitative Study.

BACKGROUND: Spouses often undertake the main caring role for a partner with primary malignant brain tumor (PMBT). Yet, demanding and challenging caring responsibilities especially because of the partner's cognitive declines can affect the spouse caregiver's well-being. OBJECTIVE: The aim of this study was to investigate spouses' experiences of suffering in their role as main caregiver of a partner with PMBT. METHODS: A hermeneutical qualitative design was used to collect and analyze data. Ten spouses (aged 36-76 years) were interviewed in depth twice 1 year apart, using semistructured interview guides. RESULTS: The spouse caregivers' experiences of suffering in their role as their partner's main caregiver were interpreted according to 3 central themes: "Enduring everyday life," "Being overlooked and hurt," and "Being acknowledged and feeling good." CONCLUSION: Spouse caregivers of a partner with PMBT are suffering from exhaustion and suppression of their own emotions to endure the caring responsibilities. They need support to manage their everyday hardship; however, their experiences seem to be easily overlooked. This causes disappointment and hurts their dignity. Acknowledgment through simple acts of practical help or time to talk are consoling and alleviate their experiences of suffering. IMPLICATIONS FOR PRACTICE: An intervention that supports healthcare professionals to facilitate the spouse caregivers' suffering is welcoming. The focus of the intervention may involve a sensitive awareness toward the spouse caregiver's individual resources and limitations and the relational and communicative competences of the healthcare professionals in their encounters with spouse caregivers that avoid hurting the spouse caregiver's dignity.

Parent Perceptions of Caregiver-Mediated Telemedicine Tools for Assessing Autism Risk in Toddlers.

Telemedicine tools have potential for increasing access to diagnostic services for children with autism spectrum disorder (ASD). Past work has utilized tele-assessment procedures in which remote psychologists observe administration of interactive screening instruments by trained, on-site providers. Although promising, this approach relies on two clinicians, limiting its efficiency and scalability. The present study examined the use, acceptability, and parents' perceptions of two caregiver-mediated tools for assessing ASD risk in toddlers, in which remote clinicians guided parents to complete interactive screening activities with their children. Most parents found tele-assessment to be comfortable, and many reported liking the parent-led nature of these tools. Parents also offered constructive feedback, which was used to modify the tele-assessment process for future study.

Use of the TELE-ASD-PEDS for Autism Evaluations in Response to COVID-19: Preliminary Outcomes and Clinician Acceptability.

The COVID-19 pandemic has caused unprecedented disruptions to healthcare, including direct impacts on service delivery related to autism spectrum disorder (ASD). Caregiver-mediated tele-assessment offers an opportunity to continue services while adhering to social distancing guidelines. The present study describes a model of tele-assessment for ASD in young children, implemented in direct response to disruptions in care caused by the COVID-19 pandemic. We present preliminary data on the outcomes and provider perceptions of tele-assessments, together with several lessons learned during the period of initial implementation.

Ethical dilemmas experienced by spouses of a partner with brain tumour.

BACKGROUND: Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses. AIM: The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour. RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT: A phenomenological and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses' homes or at the hospital. ETHICAL CONSIDERATION: Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained. FINDINGS: The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner's life had changed considerably. The main theme that emerged therefore was 'oscillating in a changing relationship'. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: 'doing the right thing in unpredictable daily situations'; 'torn between patience and guilt'; and 'living in a time of uncertainty, hope and despair'. CONCLUSION: Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses' married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners' well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners' progressing illness.

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key.

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces. Methods: Young adults (N = 151; 79% female; M = 19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions. Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces. Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.

Cognitive Predictors of Parental Rescue Behavior and Malleability of Behavior Using a Brief Psychoeducation Intervention.

Cognitive factors, such as beliefs that anxiety is harmful, may lead parents to engage excessively in over-controlling parenting practices, such as "rescuing" children from distress. The present study examined whether parental rescue behavior, or the speed at which parents intervened to rescue an increasingly distressed child during an audio paradigm, was associated with beliefs about child anxiety. We also evaluated the impact of psychoeducation on rescue behavior during the audio paradigm. A nonclinical sample of 310 parents was recruited from an online crowdsourcing platform. Findings support the hypothesis that parents' stronger beliefs that anxiety is harmful relate to parents' faster speed of rescue. Additionally, participants who received psychoeducation delayed their rescue responses more than did participants who received benign information. Findings add to the growing body of evidence that cognitive factors contribute to countertherapeutic parent behavior and indicate that psychoeducation can be an important component of family-based child anxiety treatment.