Positive Aspects of Caregiving Experience among Caregivers of Patients with Dementia.

OBJECTIVE: To assess the positive aspects of caregiving and its correlates among caregivers of patients with dementia. METHODS: A total of 55 primary caregivers of patients with dementia were invited to complete the Scale for Positive Aspects of Caregiving Experience (SPACE), Coping Checklist, Social Support Questionnaire, and World Health Organization Quality of Life-BREF version. Caregivers were also assessed by a clinician using the Burden Interview Schedule. Patients were assessed using the Hindi Mental State Examination and Instrumental Activities of Daily Living Scale. RESULTS: The mean SPACE domain score was highest for motivation for caregiving role (2.63) followed by caregiver satisfaction (2.54), caregiving personal gains (2.4), and self-esteem and social aspect of caring (2.23). More educated caregivers scored significantly lower in the self-esteem and social aspect of caring. Married caregivers had a higher mean score in the motivation for caregiving role. There were some correlations between subjective burden and various SPACE domains, but the total objective burden score had no correlation with the SPACE. Higher use of avoidance coping was associated with a positive caregiving experience. Stronger social support was associated with higher score in the motivation for caregiving role. Higher level of caregiver burden in various domains was associated with lower motivation for caregiving. Caregiver satisfaction was associated with better quality of life for caregivers in terms of the environment. CONCLUSIONS: A positive caregiving experience for primary caregivers of patients with dementia is associated with both objective and subjective burdens, avoidance coping, and perceived social support.

HIV Clade-C Infection and Cognitive Impairment, Fatigue, Depression, and Quality of Life in Early-Stage Infection in Northern Indians.

HIV disease progression is associated with declining quality of life and overall health status, although most research in this domain has been conducted among Western populations where B is the infecting clade. This study sought to determine the effects of early-stage clade-C HIV infection (CD4 count ≥400 cells/mm(3)) on neurocognitive functioning, cognitive depression, and fatigue by comparing a matched sample of HIV-positive and HIV-negative Northern Indians. This study also examined the impact of these factors on quality of life within the HIV-positive individuals. HIV-positive participants demonstrated reduced cognitive functioning, increased fatigue, and lower quality of life. Fatigue and cognitive impairment interacted to negatively impact quality of life. Results suggest that early-stage HIV clade-C-infected individuals may experience subclinical symptoms, and further research is needed to explore the benefit of therapeutic interventions to ensure optimal clinical outcomes and maintain quality of life in this vulnerable population.

Positive aspects of caregiving and its correlates in caregivers of schizophrenia: a study from north India.

OBJECTIVE. To study the positive aspects of caregiving and its correlates in primary caregivers of patients with schizophrenia. METHODS. A total of 100 patients with schizophrenia and their primary caregivers were evaluated. Regarding the caregivers, their positive aspects of caregiving were assessed on the Scale for Positive Aspects of Caregiving Experience (SPACE). To examine the correlates of positive aspects of caregiving, they were also assessed on the Family Burden Interview (FBI) Schedule, the Involvement Evaluation Questionnaire (IEQ), coping checklist, the Social Support Questionnaire, the World Health Organization Quality of Life-BREF (Hindi version), the WHO Quality of Life-Spirituality, Religiousness and Personal Beliefs Scale, as well as the General Health Questionnaire-12. The patients were assessed on the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale. RESULTS. On the SPACE, the highest mean score was seen in the domain of motivation for the caregiving role (2.7), followed by that of caregiver satisfaction (2.4) and caregiver gains (2.3). The mean score was least for the domain of self-esteem and social aspect of caring (1.9). The SPACE domain of caregiver satisfaction correlated negatively with many aspects of burden as assessed by FBI Schedule and coping as assessed by the coping checklist; whereas the self-esteem and social aspect of caring domain correlated positively with worrying-urging II domain and the total IEQ score. No significant correlations between the SPACE and socio-demographics as well as most of the clinical variables were noted. Motivation for the caregiving had a positive correlation with the PANSS negative symptom scale. Multiple correlations were found between the SPACE and quality of life, suggesting that higher positive caregiving experience was associated with better quality of life in caregivers. CONCLUSION. Caregivers of patients with schizophrenia do enjoy positive aspects of caregiving while taking care of their ill relatives. In these caregivers, the positive aspects of caregiving were associated with better quality of life.

Scale for positive aspects of caregiving experience: development, reliability, and factor structure.

OBJECTIVE. To develop an instrument (Scale for Positive Aspects of Caregiving Experience [SPACE]) that evaluates positive caregiving experience and assess its psychometric properties. METHODS. Available scales which assess some aspects of positive caregiving experience were reviewed and a 50-item questionnaire with a 5-point rating was constructed. In all, 203 primary caregivers of patients with severe mental disorders were asked to complete the questionnaire. Internal consistency, test-retest reliability, cross-language reliability, split-half reliability, and face validity were evaluated. Principal component factor analysis was run to assess the factorial validity of the scale. RESULTS. The scale developed as part of the study was found to have good internal consistency, test-retest reliability, cross-language reliability, split-half reliability, and face validity. Principal component factor analysis yielded a 4-factor structure, which also had good test-retest reliability and cross-language reliability. There was a strong correlation between the 4 factors obtained. CONCLUSION. The SPACE developed as part of this study has good psychometric properties.

Prospective psychosocial evaluation of related kidney donors: Indian perspective.

With increasing acceptance of living organ transplantation and growing numbers of organ donors, it becomes important to look for any adverse outcomes in this population. Prospective psychosocial evaluation of living related donors and assessment of the outcome of donation process was done. We also tried to identify any risk factors associated with any adverse event. Between January 2003 and December 2003, 75 consecutive donors (mean age 42.8 +/- 11.6 years; M:F 54:21) were interviewed preoperatively and at 3 months postoperatively based on a 57-item questionnaire. Objective assessment of anxiety, depression, and social support was done with "modified Beck's depression inventory," "Speilberg's state and trait anxiety," and "social support" questionnaires. The majority (85.3%) of donors had volunteered for donation. There were no major depressive or anxiety disorders following donation. Though 21.3% donors perceived some negative impact on their health, none regretted the decision to donate and most (96%) would encourage organ donation. Prolonged donor hospitalization, persistent pain, poor recipient reciprocation, or recipient death were associated with a poor psychosocial outcome.

Life events and social support in married schizophrenics.

Life events are associated with relapse in schizophrenia. However, the role and interplay of marriage and social support have not been explored in research on schizophrenia, especially stable patients. Life events and social support were assessed in two groups comprising 30 married and an equal number of unmarried patients of schizophrenia. The time frame for these assessments was a period of 6 months prior to such evaluation. The married group reported higher stress score and greater number of undesirable life events. Negative correlation was present for social support with number of undesirable life events in the sample as a whole. Hence, it is concluded that marriage leads to experiencing more stress but there are other psychosocial variables mitigating the same and preventing relapse.

Resident attrition in obstetrics and gynecology.

OBJECTIVE: Our goal was to determine the rate of attrition from obstetrics and gynecology residency programs. STUDY DESIGN: The Council on Resident Education in Obstetrics and Gynecology sent questionnaires to all 295 obstetrics and gynecology residency program directors in the United States and Canada. These programs represent 4306 postgraduate-year 1 through 4 (or 5) resident positions each year. The program directors were asked the number of residents who left voluntarily or were dismissed in a 2-year period and the reasons they left. RESULTS: In a 2-year period 299 residents left or were dismissed (6.94% over 2 years, or 3.47% per year). Only 88 (1% per year) left specifically because they decided they preferred a different discipline. CONCLUSION: The rate of attrition from obstetrics and gynecology residency programs is not excessively high.

Construction and standardization af a sex knowledge and attitude questionnaire (skaq), in simple hindi, for north Indian population.

A self-administered questionnaire (SKAQ) in simple Hindi was constructed and standardized for assessing the knowledge and attitude of a north Indian population towards sex. SKAQ is a 55- item questionnaire split into two parts: a 35-item knowledge-part with dichotomous choice of responses and a 20-item attitude-part scorable on 3-point Likert scale. Higher scores indicated a better knowledge and a liberal attitude. Its test-retest reliability was established and discriminant validity demonstrated. Both males and females showed poor knowledge about and entertained conservative attitudes. Surprisingly, normal subjects were no different from patients with sexual problems.

Life events in psychiatrically sick children.

There are some studies to suggest that the effects of life stress on children and adolescents may be similar to those found in adults. Boyce et al. (1977) demonstrated a relationship between life stress and respiratory tract illness, Bedell et al. (1977) using chronically ill children as subjects, found life stress to be correlated with day to day changes in health status. Padilla et al. (1976) have found life stress to be related to accident frequency in children; Hudgens (1974) demonstrated a relationship between life stress and depression among adolescents. Similarly high number of stressful life events were found associated with enuresis (Douglas 1973) and psychiatric disorders in children (Heisel et al., 1973). More recent studies have been by Goodyer et al. (1985); and Kashani et al. (1981) reporting an association between emotional diaorders in children and undesirable life events.

Psychological aspects of haematological malignancies.

Sixty nine patients with various types of haematological malignancies were studied. Chronic myeloid leukaemia (n =32) was the commonest diagnosis. The patients were assessed on Hamilton Rating Scale for Depression, PGI-N(2) Health Questionnaire and Presumptive Stressful Life Events Scale and those who had scores above the cut off points for Hamilton Rating Scale and/or PGI-N(2) Health Questionnaire were assessed on Present State Examination. The patients were followed up at 3 and 6 months interval. At 3 months 51 patients were re-assessed whilst at 6 months only 26 could be re-evaluated. There were no significant changes in scores of Hamilton Rating scale and PGI-N(2) Health Questionnaire at intake and subsequent follow-up assessments. No significant correlations between stressful life experience and severity of illness emerged. Twenty nine patients were interviewed on Present State Examination and of these 20 had diagnosable depressive neuroses- From consultation liaison psychiatric point of view, provision of psychiatric help to these patients is discussed.

Cannabis and cognitive functions: a prospective study.

Psychological tests measuring intelligence, memory and other cognitive functions were given to 26 heavy cannabis users (mean duration of cannabis use 6.76 years; average daily intake 150 mg THC). Compared with a control group, the cannabis users were found to react slowly in perceptuo-motor tasks, but not to differ in intelligence or memory tests. The users suffered disability in personal, social and vocational areas and indicated higher psychoticism and neuroticism scores.