Experiences of Loneliness Associated with Being an Informal Caregiver: A Qualitative Investigation.

Although providing care to a family member or friend may provide psychological benefits, informal (i.e., unpaid) caregivers also encounter difficulties which may negatively affect their quality of life as well as their mental and physical health. Loneliness is one important challenge that caregivers face, with this psychological state being associated with morbidity and premature mortality. Although previous research has identified loneliness as an issue associated with being an informal caregiver, there is a paucity of evidence that attempts to understand this phenomenon in depth. This study aimed to examine informal caregivers' reflections on, and accounts of, experiences of loneliness linked to their caregiving situation. As part of a cross-sectional, qualitative study, sixteen semi-structured interviews were conducted with 8 spousal caregivers, 4 daughters caring for a parent, 3 mothers caring for a child (or children), and 1 woman looking after her partner. The cared-for persons were suffering from a range of mental and physical health conditions (e.g., dementia, frailty due to old age, multiple sclerosis, depression, autism). Data were analyzed using an inductive thematic analysis. Experiences of loneliness were described by reference to a context of shrunken personal space and diminished social interaction caused by the restrictions imposed by the caregiving role. Loneliness was also articulated against a background of relational deprivations and losses as well as sentiments of powerlessness, helplessness, and a sense of sole responsibility. Social encounters were also seen to generate loneliness when they were characterized by some form of distancing. Though not all sources or circumstances of loneliness in caregivers are amenable to change, more opportunities for respite care services, as well as a heightened sensibility and social appreciation of caregivers' valued contributions could help caregivers manage some forms of loneliness.

Counter-Discourse Activism on Social Media: The Case of Challenging "Poverty Porn" Television.

In this paper we investigate how online counter-discourse is designed, deployed and orchestrated by activists to challenge dominant narratives around socio-political issues. We focus on activism related to the UK broadcast media's negative portrayal of welfare benefit claimants; portrayals characterised as "poverty porn" by critics. Using critical discourse analysis, we explore two activist campaigns countering the TV programme Benefits Street. Through content analysis of social media, associated traditional media texts, and interviews with activists, our analysis highlights the way activists leverage the specific technological affordances of different social media and other online platforms in order to manage and configure counter-discourse activities. We reveal how activists use different platforms to carefully control and contest discursive spaces, and the ways in which they utilise both online and offline activities in combination with new and broadcast media to build an audience for their work. We discuss the challenges associated with measuring the success of counter-discourse, and how activists rely on combinations of social media analytics and anecdotal feedback in order to ascertain that their campaigns are successful. We also discuss the often hidden power-relationships in such campaigns, especially where there is ambiguity regarding the grassroots legitimacy of activism, and where effort is placed into controlling and owning the propagation of counter-discourse. We conclude by highlighting a number of areas for further work around the blurred distinctions between corporate advocacy, digilantism and grassroots activism.

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study.

BACKGROUND: Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access. AIM: To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention. DESIGN AND SETTING: Qualitative methods underpinned by the theory of planned behaviour in primary care in Lincolnshire and Nottinghamshire. METHOD: Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia. RESULTS: A total of 23 health professionals and 28 patients were interviewed. Features designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor-patient relationship, professional support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful information could be distinguished from less useful or potentially incorrect information. CONCLUSION: Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy.

Canine responses to hypoglycemia in patients with type 1 diabetes.

OBJECTIVE: Anecdotal evidence suggests that domestic dogs may be able to detect hypoglycemia in their human caregivers; scientific investigation of this phenomenon, however, is sorely lacking. This study thus aimed to investigate how pet dogs respond to the hypoglycemic episodes of their owners with type 1 diabetes. METHODS: Two hundred and twelve dog owners (64.2% female) with medically diagnosed type 1 diabetes participated in the study. All participants owned at least 1 dog. Each person completed a purpose-designed questionnaire developed to collect information on their dogs' responses (if any) to their hypoglycemic episodes. RESULTS: One hundred and thirty-eight (65.1%) respondents indicated that their dog had shown a behavioral reaction to at least one of their hypoglycemic episodes, with 31.9% of animals reacting to 11 or more events. Canine sex, age, breed status, and length of pet ownership were unrelated to hypoglycemia-response likelihood. Thirty-six percent of the sample believed that their dogs reacted most of the times they went "low"; 33.6% indicated that their pets reacted before they themselves were aware they were hypoglycemic. Dogs' behavioral responses to their owners' hypoglycemic episodes varied. Most animals behaved in a manner suggestive of attracting their owners' attention, for example, vocalizing (61.5%), licking them (49.2%), nuzzling them (40.6%), jumping on top of them (30.4%), and/or staring intently at their faces (41.3%). A smaller proportion showed behavioral responses suggestive of fear, including trembling (7.2%), running away from the owner (5.1%), and/or hyperventilating (2.2%). CONCLUSIONS: The findings suggest that behavioral reactions to hypoglycemic episodes in pet owners with type 1 diabetes commonly occur in untrained dogs. Further research is now needed to elucidate the mechanism(s) that dogs use to perform this feat.