14 research outputs found
Caregiver exposure to critical events and distress in home-based palliative care in Germany a cross-sectional study using the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale
Abstract Background Lay family caregivers of patients receiving palliative care often confront stressful situations in the care of their loved ones. This is particularly true for families in the home-based palliative care settings, where the family caregivers are responsible for a substantial amount of the patientâs care. Yet, to our knowledge, no study to date has examined the family caregiversâ exposure to critical events and distress with home-based palliative care has been reported from Germany. Therefore, we attempt to assess family caregiver exposure to the dying patientâs critical health events and relate that to the caregiverâs own psychological distress to examine associations with general health within a home-based palliative care situation in Germany. Methods A cross-sectional study was conducted among 106 family caregivers with home-based palliative care in the Federal State of North Rhine Westphalia, Germany. We administered the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale. Descriptive statistics and linear regression models relating general health (SF-36) were used to analyze the data. Results The frequency of the caregiverâs exposure, or witness of, critical health events of the patient ranged from 95.2% âpain/discomfortâ to 20.8% âfamily caregiver thought patient was deadâ. The highest distress scores assessing fear and helpfulness were associated with âfamily caregiver felt patient had enoughââ and âfamily caregiver thought patient was deadâ. Linear regression analyses revealed significant inverse associations between SCARED critical health event exposure frequency (betaâ=â.408, pâ=â.025) and total score (betaâ=â.377, pâ=â.007) with general health in family caregivers. Conclusions Family caregivers with home-based palliative care in Germany frequently experience exposure to a large number of critical health events in caring for their family members who are terminally ill. These exposures are associated with the family caregiverâs degree of fear and helplessness and are associated with their worse general health. Thus the SCARED Scale, which is brief and easy to administer, appears able to identify these potentially upsetting critical health events among family caregivers of palliative care patients receiving care at home. Because it identified commonly encountered critical events in these patients and related them to adverse general health of family caregivers, the SCARED may add to clinically useful screens to identify family caregivers who may be struggling
Application of Remote Sensing for Policy, Planning and Management in Forestry and Agriculture
Deciduous tree species classification using object-based analysis and machine learning with unmanned aerial vehicle multispectral data
Role of the HLA System in the Pathogenesis of Dupuytrenâs Disease
Dupuytrenâs disease (DD) is a familial, fibroproliferative, irreversible, and progressive disease of the palmar fascia, yet with unknown etiology. However, there is compelling evidence which has consistently suggested a genetic ethiopathogenesis given the high occurrence among the Northern European extraction, familial nature, and demonstration of concordance in twins. DD is an incurable, recurrent, and potentially debilitating disease with limited and ineffective treatments. Although a number of possible candidate genes have been investigated including matrix metalloproteinases (MMPs) and transforming growth factor-beta (TGF-ÎČ) genes, as yet, no consistent genetic biomarker has been identified for DD. The highly polymorphic human leukocyte antigen (HLA) region is an ideal biomarker target. There have been some coherent data within the literature to suggest a genotype to phenotype association between certain HLA loci and a number of fibrotic disorders such as keloid and scleroderma, markedly with class II molecules and disease pervasiveness and clinical progression. The aim of this review, therefore, was to investigate the evidence indicative of both positive and negative associations between particular HLA alleles and DD. There is a clear association with specific HLA alleles and predilection or protection to DD, though there is a pressing need for further supportive data. The most promising of links to the HLA region in terms of a definitive genetic biomarker is with the class II HLA-DR loci. This paper presents a detailed account of the immunogenetic component of DD and explores the possible mechanisms of association between specific HLA molecules and susceptibility to DD
The association between attendance of midwives and workload of midwives with the mode of birth: secondary analyses in the German healthcare system
Ammonite Fauriella boissieri (Pictet), the index species of the Berriasian upper zone from the Crimean Mountains
Caregiver exposure to critical events and distress in home-based palliative care in Germany a cross-sectional study using the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale
The Dualisation of Social Policies towards Young People in France: Between Familism and Activation
The mass expansion of higher education, the extension of the typical duration of studies and growing difficulties in entering the labour market have changed the transition from youth to adulthood. For these reasons some authors refer to youth as a ânew age of lifeâ (Galland, 1993) or, in psychological terms, as âemerging adulthoodâ (Arnett, 2000). In the literature on youth and the transition to adulthood, many typologies have been proposed in order to analyse the various possible institutional national arrangements that shape this transition (Breen and Buchmann, 2002; Van de Velde, 2008; Wallace and Bendit, 2009; Walther, 2006). They all rely on the seminal three-term typology of âwelfare regimesâ developed by Esping-Andersen (Esping-Andersen, 1990) and further modified by Gallie and Paugam (Gallie and Paugam, 2000), who added a fourth type following the insights of Ferrera (Ferrera, 1996)