ABSTRACT
Caring for veterans with dementia is burdensome for family caregivers. This exploratory study tested the efficacy of an innovative, spiritually based mantram caregiver intervention delivered using teleconference calls. A prospective, within-subjects, mixed-methods, and 3-time repeated-measures design with 36-week follow-up telephone interviews was conducted. Sixteen caregivers (94% women, 94% Whites with mean age 69.2 years, SD = 10.35 years) completed the intervention. Significant effects for time and linear terms were found for decreasing caregiver burden, perceived stress, depression, and rumination and for increasing quality of life enjoyment and satisfaction, all with large effect sizes. Findings suggest that teleconference delivery of a spiritually based caregiver intervention is feasible.
Subject(s)
Caregivers/psychology , Dementia , Social Support , Stress, Psychological/therapy , Aged , California , Female , Hospitals, Veterans , Humans , Male , Outpatient Clinics, Hospital , Relaxation Therapy , Religion , Stress, Psychological/prevention & control , TelephoneABSTRACT
PURPOSE: The purpose of this study was to develop and test a brief scale (Brief Evaluation of Medication Influences and Beliefs [BEMIB]) designed to identify patients who are more likely to be nonadherent to their antipsychotic medication. METHODS: Sixty-three outpatients with schizophrenia and related psychotic disorders were enrolled and given an assessment battery including the BEMIB, a previously published adherence scale, extrapyramidal symptom rating scales, and an adherence assessment with patient self-report and prescription refill records. The BEMIB consisted of 8 statements derived from the health belief model with a 5-point Likert-type scale for each statement. Subjects chose a single answer for each item depending on their level of agreement or disagreement. RESULTS: According to refill records, subjects meeting BEMIB-based criteria for nonadherence had significantly larger gaps in antipsychotic therapy (greater nonadherence) compared with those of participants not meeting criteria for nonadherence. For the 1-week test-retest reliability, the BEMIB total score and 5 of 8 single items correlated significantly. BEMIB total scores correlated significantly with an established assessment of adherence (Drug Attitude Inventory), demonstrating adequate construct validity. CONCLUSION: The BEMIB represents a promising scale for identifying patients more likely to be nonadherent to their medications.
Subject(s)
Culture , Patient Compliance/psychology , Surveys and Questionnaires , Aged , Antipsychotic Agents/therapeutic use , Feasibility Studies , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales/statistics & numerical data , Schizophrenia/drug therapy , Schizophrenia/epidemiology , Statistics, NonparametricABSTRACT
The authors measured serum levels of haloperidol (HL) in outpatients ages 45-83 years with psychosis treated with HL for at least 1 month. Blood was collected from 32 patients with either schizophrenia (n = 23) or Alzheimer's disease (AD) (n = 9). HL daily dose was greater in patients with schizophrenia (median age, 59) than in AD patients (median age, 80) (P < 0.0005), but no significant group differences in HL serum concentrations were observed. In the total sample, age correlated negatively with HL dose (P < 0.001) and positively with the ratio of serum HL level/dose (P < 0.05). The ratio of HL level/dose was higher in the elderly AD patients than in younger subjects with schizophrenia (P < 0.005). Serum HL levels were much lower than those reported in younger schizophrenia patients, but comparable to those reported in elderly patients with AD. Aging-related and disease-associated pharmacokinetic and pharmacodynamic changes may reduce the need for higher neuroleptic doses as well as higher blood levels in older patients.
