NECESIDADES Y PROBLEMAS DE LAS PERSONAS CUIDADORAS FAMILIARES DE MAYORES CON DEMENCIA/ENFERMEDAD DE ALZHEIMER: UN ESTUDIO CUALITATIVO

Objetivos: Identificar, clasificar y analizar las necesidades y problemas percibidos por las personas cuidadoras familiares de mayores con demencia durante el proceso del cuidado. Metodología: Estudio cualitativo de teoría fundamentada constructivista. Se realizaron siete grupos focales. Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Resultados: Se identificaron necesidades percibidas por las personas cuidadoras relacionadas con el manejo de los cuidados del familiar con demencia y con el manejo de su propia vida. Se constató que la persona cuidadora desempeña su rol en una realidad caracterizada por el cambio; el reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora y los factores que facilitan su labor cuidadora. Conclusión: Las necesidades percibidas por las personas cuidadoras familiares son complejas, cambiantes y están interrelacionadas. Además, el proceso de adaptación de las personas cuidadoras de familiares con demencia podría mejorar mediante un mayor apoyo formal en las primeras fases del cuidado y con la adaptación de las intervenciones a cada fase de la evolución del rol cuidador.Aim: To identify, classify and analyse caregivers’ of elderly people with dementia perceived needs and problems among the care process. Methods: Qualitative study based on constructivist grounded theory. Seven focus groups were conducted. Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Results: It was identified needs perceived by family caregivers related to the management in caring for the relative with dementia and related to the management of the caregivers’ own cares. Family caregivers perform their role in a context characterized by personal change; the challenge of adaptation lies in the balance between the problems that hamper adaptation to the changes of the caregiver and the factors that facilitate the caregiver role Conclusion: The needs perceived by family caregivers are complex, changable, and interrelated. In addition, the adaptation of family caregivers to caring for a person with dementia could be improved by strengthening formal support in the early stages of care and by interventions adapted to each phase in the development of the caregiver role.Tesis Univ. Jaén. Departamento de Enfermería. Leída el 13 de junio de 2017

Association between Sense of Coherence and Mental Health in Caregivers of Older Adults

The purpose of this study was to analyze association between sense of coherence and perceived burden, anxiety, depression, and quality of life in caregivers of older adults. A cross-sectional study was carried out with a probabilistic sample of 132 caregivers of older relatives from the regions of Jaén, Spain. The measures assessed were sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index of Robinson), anxiety and depression (Goldberg Scale), and quality of life (Health Questionnaire SF-12). The main analyses included bivariate analysis using Pearson’s correlation coefficient and multivariate analysis through canonical correlation analysis. Our findings show that the sense of coherence explained 50.8% of the variance shared between subjective burden, anxiety, depression, and quality of life. We highlighted manageability as the variable within the dimensions of the sense of coherence with the greatest participation in the model. The sense of coherence may be an important protective factor for the mental health of the caregiver of dependent elderly relatives

Problemas en el proceso de adaptación a los cambios en personas cuidadoras familiares de mayores con demencia

ResumenObjetivoIdentificar y analizar los problemas que surgen en el proceso de adaptación de la persona cuidadora a los cambios durante el cuidado familiar a una persona afectada por demencia.MétodoEstudio cualitativo basado en la metodología de la teoría fundamentada constructivista de Charmaz. Se realizaron siete grupos focales en diferentes centros de atención primaria de salud en la provincia de Jaén (España). Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Se llevó a cabo una triangulación del análisis para favorecer la validez interna del estudio.ResultadosSe obtuvieron tres categorías centrales, que fueron «Cuidados cambiantes», «Problemas en el proceso de adaptación a los cambios» y «Factores facilitadores del proceso de adaptación a los cambios». La persona cuidadora desempeña su rol en una realidad caracterizada por el cambio, tanto personal como de la persona a la que cuida y su contexto social y cultural. El reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora a las nuevas situaciones de cuidado y los factores que facilitan su labor cuidadora.ConclusionesLa escasez de apoyo formal y el infradiagnóstico de la demencia dificultan la adaptación de la persona cuidadora al cuidado de una persona afectada por demencia. El proceso de adaptación podría mejorar reforzando el apoyo formal en las primeras fases del cuidado para reducir el estrés del proceso de aprendizaje autodidacta de las familias cuidadoras, así como adaptando las intervenciones a cada fase de la evolución del rol cuidador.AbstractObjectiveTo identify and analyse problems in adapting to change among the family caregivers of relatives with dementia.MethodQualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity.ResultsWe obtained three main categories: ‘Changing Care’, ‘Problems in the process of adapting to change’ and ‘Facilitators of the process of adapting to change’. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role.ConclusionsThe adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role

The start of caring for an elderly dependent family member: A qualitative metasynthesis

Background: The family often takes care of an elderly person who suddenly becomes dependent. This greatly affects different aspects of the caregivers’ lives. The aim of this study is to explore the initial experiences, during the first year of care, of persons who suddenly become caregivers for elderly dependent relatives. Methods: A search in CINAHL, PsycINFO, WOS, Medline, and Scopus and a metasynthesis of qualitative research were conducted including 19 articles. Results: Three categories were developed to explain the process of becoming a caregiver ‘taking on the role’ (life changes, uncertainty and confusion, and acceptance or resistance); ‘beginning to realise’ (new needs, impact, and appraisal); and ‘implementing strategies’ (seeking help and self-learning, reordering family and social relationships, solving problems, and devising strategies to decrease negative emotions and stress). Conclusions: The synthesis provides a comprehensive understanding of the experience of becoming a caregiver in order to help health-care professionals to adapt care plans to this situation.No proced

Perceptions, Motivations, and Empowerment Strategies of Midwives in Rural and Remote Areas of Northern Morocco

The shortage of midwives is a problem in rural and remote areas. This is mainly the consequence of job insecurity and difficult living conditions. The present study aimed to identify and analyse the perceptions and motivations of midwives in rural and remote areas of northern Morocco on the quality of their working life and the motivational factors and empowerment strategies they use to maintain and develop their work. It is a qualitative study that follows Van Manen’s hermeneutic phenomenology approach. Three focus groups and in-depth interviews were conducted with 15 midwives from rural and remote areas. The results indicate that midwives in rural and remote areas have a negative perception of the quality of the work and their personal life because of the scarcity of basic resources, unfavourable working conditions, and the personal sacrifices they have to make to support themselves. However, some factors favour their efforts. Therefore, there is a need to promote intersectoral policies that focus on improving material and human resources, as well as the working and personal conditions of midwives and the factors that support and empower them

Perceived needs of the family caregivers of people with dementia in a mediterranean setting: A qualitative study

The purpose of this study was to identify, classify and analyze the perceived needs of caregivers of elderly people with dementia during the care process. A descriptive phenomenological qualitative study using seven focus groups was conducted in different primary health care centers in the province of Jaén (Spain) between July 2012 and February 2013. Eighty-two family caregivers who were caring for people with dementia in different stages of the disease were selected by purposeful maximum variation sampling. Data were analyzed and organized thematically, considering the semantic and pragmatic content and field notes. Two main categories of the perceived needs of caregivers were identified. The first was related to the management of caring for a relative with dementia, and the second was related to the management of the caregivers’ own care. Our findings support the provision of comprehensive interventions for the improvement of caregivers’ emotional health that encompass more than one care need. This is where psycho-educational interventions aimed at managing the various aspects of dementia and self-care in caregivers can be accommodated. In addition, proactive interventions to develop important skills to care for a relative with dementia, which are not perceived as needs by the caregivers, are needed. These include skills in family negotiation, planning and searching for resources outside the family

Effectiveness of Internet-Based or Mobile App Interventions for Family Caregivers of Older Adults with Dementia: A Systematic Review

Introduction: Global aging presents socioeconomic and health challenges. Dementia, a growing concern, affects millions of older adults, intensifying the burden on family caregivers. E-health interventions offer hope through technological solutions, although current research is limited. This study evaluated the effectiveness of internet-based or mobile app interventions for family caregivers of older adults with dementia. Methodology: A systematic review with a narrative synthesis was conducted using databases (PubMed, CINAHL, Scopus, LILACS, and PsycInfo) and the bibliographies of retrieved articles, with no restrictions on time or language. Results: The search yielded 2092 results, of which 22 studies met the inclusion criteria, encompassing a total of 2761 family caregivers. Twenty-one different outcomes were evaluated and classified into three main types of interventions: psychoeducational, psychotherapeutic, and multicomponent. Conclusions: The study highlights the importance of internet-based and mobile app interventions in supporting family caregivers of older adults with dementia. These interventions positively affect many aspects of caregiver well-being, suggesting their utility in addressing this group’s emotional, social, and self-care needs

Relationship between sense of coherence and health-related behaviours in adolescents and young adults: a systematic review

Background: The sense of coherence is developed through the learning process and contributes to the positioning of individuals in the health-disease continuum, facilitating successful and adaptive personal outcomes. Health-related behaviours represent a health determinant of utmost importance for public health and the development of adolescent and youth health promotion policies, as they are related to the main risk factors and problems of morbidity and mortality in our society. Previous studies have analysed the relationship between sense of coherence and only some individual health outcomes such as oral health, the relationship of sense of coherence with smoking and alcohol consumption, concluding that salutogenic factors are related to quality of life and preventive behaviours. The aim of this systematic review was to describe the relationship of sense of coherence with different health-related behaviours investigated so far in the adolescent and youth population. Methods: A systematic review was carried out in databases (PubMed, CINAHL, Scopus and PsycInfo) and in the bibliographies of the retrieved articles, without limitation of time or language. Associations between sense of coherence and health-related behaviours have been assessed. Results: A total of 1214 investigations were reviewed and 21 of them were included in this systematic review. The relationship between sense of coherence and eight health-related behaviours were identified (alcohol use, physical activity, tobacco use, eating habits, rest periods, use of illegal substances, behaviours related to oral health and time spent in games on the computer). Conclusions: Our results increase the available evidence and support the solid relationship of the sense of coherence with health behaviours both as a protective factor against risk behaviours and for its positive association with preventive and health promoting behaviours of adolescents, young adults and university students

Factors Influencing Nutritional Status in Hospitalized Individuals Aged 70 and above

: Background: Older adults are vulnerable to malnutrition due to physical, psychological, and social factors. Malnutrition, a prevalent and modifiable issue in this population, is associated with an elevated risk of adverse clinical outcomes. The purpose of the study is to assess the nutritional status of older adult individuals admitted to a general hospital and examine its correlation with socio-health and demographic variables. Methods: The study included 239 individuals aged 70 and above, employing a cross-sectional descriptive observational approach with a convenience sampling method. Sociodemographic information was gathered, and variables such as cognitive impairment, functional capacity, comorbidities, medication consumption, and nutritional status were evaluated. Statistical analysis involved descriptive calculations, bivariate analysis, and multivariate analysis, utilizing binary logistic regression. Results: Approximately half of the sample were at risk of malnutrition, with a more notable prevalence among women. Factors such as age (OR = 1.04), cognitive impairment (OR = 1.06), functional dependence (OR = 0.96), and comorbidities (OR = 1.08) were linked to an elevated risk of malnutrition. In our regression model, age, cognitive impairment, and drug consumption emerged as significant predictors of malnutrition risk. Conclusions: Individuals aged 70 and above have a notably high prevalence of malnutrition risk, particularly among those experiencing functional dependence and cognitive impairment. In our sample, cognitive impairment in older adults, coupled with above-median drug consumption, emerges as the primary predictor for malnutrition risk

Implicación de la matriz extracelular de Bacillus subtilis en la interacción beneficiosa con la planta

Bacillus subtilis es una bacteria Gram-positiva comúnmente presente en los suelos. Algunos aislados de esta especie son capaces de promover el crecimiento en plantas (actividad PGPR, del inglés plant growth promoting rhizobacteria) y de contribuir al control de diferentes enfermedades microbianas mediante la producción de una amplia batería de metabolitos secundarios con actividad antimicrobiana y la inducción de los mecanismos de defensa de la planta. Todo ello ocurre en el contexto de una eficiente colonización y persistencia sobre la raíz, la cual se cree estar asociada a la formación de biofilms: comunidades bacterianas donde las células están englobadas en una matriz extracelular de producción propia y compuesta principalmente por proteínas y exopolisacáridos. Estudios previos han demostrado que la surfactina, uno de los metabolitos secundarios producidos por esta bacteria, está involucrada en la cascada de señalización que dispara la formación del biofilm así como en la comunicación con la planta. Esta observación conduce a plantear la hipótesis de que alguno de los metabolitos secundarios u otros componentes estructurales de la matriz extracelular pueden ser mediadores de la comunicación bacteria-semilla y tener relevancia en la actividad PGPR. En este trabajo se evalúa el papel que los distintos componentes estructurales y metabolitos secundarios presentes en la matriz extracelular de B. subtilis puedan tener en la promoción de la germinación de semillas. Valiéndonos de una batería de mutantes en dichos elementos, realizamos ensayos de bacterización de semillas para estudiar posteriormente los patrones de colonización y persistencia bacteriana en la rizosfera y el efecto sobre la actividad PGPR. Los resultados obtenidos hasta la fecha sugieren que la molécula fengicina y la proteína TasA pueden ser claves en esta función de B. subtilis