RESUMEN
OBJECTIVES: The purpose of this study was to examine the role of predictability in the relationship between caregiving demands and caregiving consequences. DESIGN: This 2-year longitudinal survey study collected from self-report questionnaires. A convenience sample of family caregivers of older persons living with dementia were recruited from a neurology clinic. RESULTS: A total of 200 family caregivers were recruited to participate. Analysis indicated predictability was a partial mediator between caregiving demand and caregiver consequences of role strain, depressive symptoms and both physical and mental components of health-related quality of life at the 2-year follow. Predictability accounted for 25 %, 28.8 %, 15.3 % and 46.5 % of the relationship between caregiving demand and caregiving consequences of role strain, depressive symptoms, physical- and mental-health related quality of life, respectively. CONCLUSIONS: The contributions of caregiving demand to outcomes of caregiver consequences were in part due family caregivers perceived predictability for caregiving.
Asunto(s)
Cuidadores , Demencia , Calidad de Vida , Humanos , Estudios Longitudinales , Demencia/enfermería , Cuidadores/psicología , Masculino , Femenino , Anciano , Encuestas y Cuestionarios , Depresión/psicología , Persona de Mediana Edad , Estrés Psicológico , Anciano de 80 o más AñosRESUMEN
This case report describes a nursing experience providing end-of-life care to a child with Niemann-Pick disease type C. The period of nursing care was from April to June 2018. After comprehensive nursing and family assessment, dyspnea and caregiver's role strain were identified as the primary nursing-care problems. Niemann-Pick is a rare disease caused by genomic abnormalities. Patients with this disease are unable to metabolize lipids, which accumulate in organs, causing hepatosplenomegaly, dyspnea, and central nervous system degeneration. There is a lack of relevant experience in medical and nursing care due to the small number of cases worldwide. It is difficult to predict the progress of this disease and the life expectancy of the patient. The complex indications of this disease complicate the caregiver burden and process of end-of-life care. Thus, the multi-disciplinary team integrated the discharge preparations, symptom control skills, and related resources to build consensus with the family. We provided nursing care continuously from hospital to home as well as improved quality of care and family cohesion and reduced caregiver load. We hope that sharing this experience provides a reference for discharge planning and end-of-life care for children with rare diseases.
Asunto(s)
Disnea/complicaciones , Enfermedad de Niemann-Pick Tipo C/enfermería , Cuidado Terminal , Niño , Disnea/terapia , Familia , Humanos , Enfermedad de Niemann-Pick Tipo C/diagnóstico , Enfermedad de Niemann-Pick Tipo C/mortalidad , Calidad de la Atención de Salud , RespiraciónRESUMEN
AIMS: To examine the role of balancing competing needs in the relationship between caregiving demand and caregiving outcomes (caregivers' role strain and depressive symptoms). BACKGROUND: Caregivers who do not balance competing needs are more likely to experience negative caregiving outcomes, suggesting that balance mediates between caregiving demand and caregiving outcomes. Identifying a mediator of negative caregiving effects may help in developing tailored interventions for family caregivers of persons with dementia. DESIGN: A cross-sectional, correlational design. METHODS: Data were collected from family caregivers' self-completed questionnaires between March 2013 - April 2014. A convenience sample of 120 family caregivers and care receivers with dementia was enrolled. We examined whether balance mediated the relationship between caregiving demand and caregiving outcomes (caregivers' role strain and depressive symptoms) by multiple regression analysis. To evaluate the significance of the indirect effect of caregiver balance, we used the Sobel test and Monte Carlo method, an alternative approach to testing mediation. RESULTS: Balancing competing needs completely mediated the association of caregiving demand with depressive symptoms and partially mediated the association of caregiving demand with role strain. CONCLUSION: Assessing caregivers' self-perceived sense of balance may help to identify caregivers at high risk for role strain and depressive symptoms. Interventions to enhance caregivers' perceived sense of balance between competing needs may provide a strategy for reducing the negative effects of caregiving.
Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Depresión/psicología , Familia/psicología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Humanos , Persona de Mediana EdadRESUMEN
PURPOSE: The aim of the study was to clinically validate the defining characteristics of the nursing diagnosis caregiver role strain in the Czech Republic. METHODS: This is a cross-sectional study. The patient-focused clinical diagnostic validity model was used for clinical validation. FINDINGS: Only two major defining characteristics were identified for caregiver role strain in a sample of 225 caregivers. CONCLUSION: The study has identified the most frequently present defining characteristics related to the nursing diagnosis caregiver role strain in a caregiver population in the Czech Republic caring for their loved ones in home settings. IMPLICATIONS FOR NURSING PRACTICE: It is important that defining characteristics aid diagnosis and direct nursing interventions.
Asunto(s)
Cuidadores/psicología , Diagnóstico de Enfermería , Estrés Psicológico , Estudios Transversales , República Checa , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: Family caregivers of older persons with dementia face negative impacts such as heightened role strain due to care receivers' incremental loss of cognitive function. Dyadic relational resources were found to protect caregivers against negative caregiving outcomes while caring for cancer patients, but had not been explored in caregivers of patients with dementia. OBJECTIVE: To explore whether the impact of caregiving demand/care receivers' cognitive functioning on caregiver role strain is moderated by dyadic relational resources. DESIGN: Cross-sectional correlational survey. SETTING: The neurological clinics of a 3700-bed medical centre, neurological ward, and day care centre affiliated with a regional hospital in northern Taiwan. PARTICIPANTS: A convenience sample of 219 family caregivers and care receivers with dementia was enrolled, with 197 (90%) completing the study questionnaires. METHOD: Data were collected from family caregivers' self-completed questionnaires from December 2010 to November 2011. We examined the moderating effects of caregiving demand/care receiver dementia severity and dyadic relational resources (mutuality, preparedness and predictability) on caregiving outcome (role strain) using hierarchical multiple regression analyses. Moderating effects were examined according to two- and three-way interaction terms in the regressions. We also explored the simple effect of each independent variable on role strain. RESULTS: The dyadic relational resources of mutuality and preparedness moderated the effects of caregiving demand on caregivers' role strain. That is, a high level of mutuality and preparedness protected caregivers from high levels of role strain, even when caregiving demand was high. Another important factor was a high level of predictability, which tended to decrease role strain. Finally, the association between care receiver cognitive functioning and caregiver role strain was influenced by the level of mutuality between caregiver and care receiver. More specifically, high levels of mutuality diminished role strain in caregivers of patients with mild dementia. CONCLUSIONS: Dyadic relational resources may moderate the effects of role strain. These findings suggest that these dyadic relational resources should be enhanced for family caregivers of patients with dementia to ease their caregiving role strain.