Factors contributing to caregiver burden in dementia in a country without formal caregiver support

This items is under embargo for 12 months from the date of publication according to Publisher's copyright policy. This is an Accepted Manuscript of an article published by Taylor & Francis in Aging & Mental Health on 31 Mar 2014, available online: http://wwww.tandfonline.com/10.1080/13607863.2014.899976Objectives: To investigate caregiver burden in dementia and explore factors associated with different types of burden in a country without formal caregiver support using a province in China as a case.Method: Cross-sectional questionnaire survey was used to collect data. One hundred and fifty-two family caregivers of people with dementia in community settings were recruited from 2012 to 2013 using convenience sampling. Objective burden was measured by caregiving hours and dementia-related financial burden. Subjective burden was measured and analysed using the Caregiver Burden Inventory and the Neuropsychiatric Inventory-Questionnaire. Multivariate regression models were employed to analyse factors associated with each type of subjective burden.Results: Five types of subjective burden were measured by the Caregiver Burden Inventory, namely, physical burden, emotional burden, time-dependence burden, developmental burden, and social burden. Caregiver distress, as a subjective burden, was measured by the Neuropsychiatric Inventory-Questionnaire and reported by relating to the severity of care recipients’ behavioural and psychological symptoms of dementia. This caregiver cohort showed a high level of physical, time-dependence, and developmental burdens, but a low level of emotional and social burdens. Factors contributing to each type of subjective burden measured by the Caregiver Burden Inventory differed from each other.Conclusion: The high level of objective and subjective burdens identified in this study suggests that government-funded formal caregiver support should be established and services should be designed to target different types of burdens and factors contributing to these burdens

NFUバン カイゴ フタンカン シャクド ノ サクセイ カイゴ ホケン セイド ドウニュウ ゼンゴ ノ カイゴ フタンカン ニカンスル オウダン ケンキュウ

The purpose of this study is to make a new scale to measure the effects of Long-term care insurance system. Four hundreds and seventy-one caregivers who care the elderly living at home voluntarily answered the questionnaire, and the subjective burden of caregivers was measured by Nihon Fukushi University (NFU) version of caregiver burden scale. As the results, NFU version of caregiver burden scale had enough reliability and validity to measure caregiver\u27s burden, and a factor analysis revealed two factors, "subjective burden of care" and "will for continuing care". Cross-sectional comparison shows reduction of subjective burden of care, however, the change was different due to community. The factors of the elderly themselves and the factors of caregivers were related to subjective burden of caregivers. Different dimensions of social network and social support were related to two subscales

Who Feels Constrained by High Debt Burdens? – Subjective vs. Objective Measures of Household Indebtedness

This paper analyzes diff erences in self-assessed debt burdens of German households confronted with an objective debt burden. Using data from the German Socio- Economic Panel, my econometric analysis shows that a household’s subjective debt burden is not only infl uenced by the current constellation of income, debt service and, possibly, the potential subsistence level, but also by expectations of the personal and overall socio-economic environment in the future (especially unemployment), as well as by further undetermined (and possibly non-fi nancial) factors. Confronted with a certain ratio of consumer debt repayments and income, women perceive signifi cantly higher subjective debt burdens. Unemployment is associated with drastically higher self-assessed debt burdens even when controlling for the overall fi nancial situation of the household. Furthermore, some discrepancies between East and West Germans are detectable. Only some diff erences in the subjective perception of objective debt burdens can be explained with personal traits (such as risk attitudes) and life satisfaction. I draw the following conclusions: First, self-assessed debt burdens contain information beyond the current economic situation, e.g., expectations on future incomes. Second, relying on subjective debt statements may lead to biased results for policy analysis if the researcher does not account for non-financial factors.Household debt; subjective, objective measures; risk aversion; gender differences

Subjective caregiver burden and anxiety in informal caregivers: a systematic review and meta-analysis

There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide

Applied Gratitude Therapy in Cerebral Palsy’s Caregiver to Reduce Subjetive Burden: A Single-Case Design

The task of caregivers could potentially lead to an experience that produces negative emotions within themselves. The negative emotions will ultimately have implications for creating a subjective burden on caregivers. This study aims to determine the effect of gratitude therapy to reduce the subjective burden on cerebral palsy caregivers. Participants in this study were 3 caregivers of cerebral palsy whose children had motor skills at 3-5 GMFCS levels and had subjective burden based on the Zarit Caregiver Burden Scale (ZCBS). The experimental design uses small n single-case type A-B-A. Hypothesis testing is done quantitatively by using visual inspection technique followed by descriptive analysis. The result of this study shows a decrease of subjective burden in all participants

Burden of Family Care-Givers and the Rationing in the Long Term Care Insurance Benefits of Japan

Long Term Care Insurance introduced in Japan in 2000 is rapidly turning into a system of rationed benefits due to financial difficulty. Based on our survey of 2500 family care-givers and the Zarit Care-Giver Burden Index, we have examined how these changes are affecting their subjective burden, following Kishida's seminary work. We have found evidence that (a)rationings in short-term-stays, day-services, or home-helper services, (b)disruptive or anti-social behaviors of the elderly, and (c)care-giver's own sleeping disorders are substantially adding to their burden. We have also found (d)a causal relationship where a higher burden is resulting in poor self-reported health.Long-term Care Insurance, Burden Index of Care-Givers, Rationning

Factors related to the quality of life in family carers of people with dementia: a meta- analysis

Objectives: This meta-analysis aimed to (1) quantitatively synthesize evidence of factors related to the quality of life (QoL) of family carers of people with dementia and (2) explore moderating factors that may influence the strength of the relationship between such potential predictive factors and carer QoL.  Methods: Studies that investigated correlations between patient/carer factors and QoL in unpaid family carers of people with dementia and were published in English, Spanish, Portuguese, or Japanese were included.  Results: Thirty-three studies were identified. The pooled correlations with carer QoL (effect size) were significantly large for depression (−0.58), significantly moderate for subjective burden (−0.47), and significantly small for people with dementia’s neuropsychiatric symptoms (−0.24). These results indicated to be robust in the context of publication bias. The results of subgroup analyses demonstrated the social and economic development status of the country where study participants resided did not moderate these effects.  Conclusion: Carer depression, subjective burden, and people with dementia’s neuropsychiatric symptoms may play a critical role in maintaining QoL of family carers regardless of the social and economic circumstances

Burden of treatment for chronic illness: a concept analysis and review of the literature

Context Treatment burden, the burden associated with the treatment and management of chronic illness, has not yet been well articulated. Objective Using Rodgers' (1989, Journal of Advanced Nursing, 14, 330–335) method of concept analysis, this review describes the ways in which treatment burden has been conceptualized to define the concept and to develop a framework for understanding its attributes, antecedents and consequences. Methods Leading databases were searched electronically between the years 2002 and 2011. To ensure the review focused on actual observations of the concept of interest, articles that did not measure treatment burden (either qualitatively or quantitatively) were excluded. An inductive approach was used to identify themes related to the concept of treatment burden. Main results Thirty articles, identified from 1557 abstracts, were included in the review. The attributes of treatment burden include burden as a dynamic process, as a multidimensional concept, and comprising of both subjective and objective elements. Prominent predisposing factors (antecedents) include the person's age and gender, their family circumstances, possible comorbidity, high use of medications, characteristics of treatment and their relationship with their health-care provider. The most dominant consequences are poor health and well-being, non-adherence to treatment, ineffective resource use and burden on significant others. Furthermore, many of these consequences can also become antecedents, reflecting the cyclic and dynamic nature of treatment burden. Conclusion The findings underscore the need for researchers and health-care professionals to engage in collaborative discussions and make cooperative efforts to help alleviate treatment burden and tailor treatment regimens to the realities of people's daily lives

Review: Burden on Family Caregivers Caring for Patients with Schizophrenia and Its Related Factors

Background: Family caregiver is the most important person who cares for patient with schizophrenia. However when care is provided for long time, he/she may experiences the burden.Purpose: The purpose was to review concept and factors related to burden on family caregivers caring for patients with schizophrenia.Method: A literatures were searched from databases: Pubmed, CINAHL, and Science Direct. Key words used to retrieve literature include caregiver burden and schizophrenia. Searching was limited in English language, full text, and the year of publication from 2000 to 2009 was used.Results: Twenty two studies were reviewed in this paper. The result showed that the caregivers caring for patients with schizophrenia experience burden. Burden was defined as a negative impact of caring for the impaired person experienced by caregiver on their activity (objective burden) or feeling (subjective burden) that involves emotional, physical health, social life, and financial status. Factors related to burden on family caregiver were grouped into: 1) caregiver‟s factors included age, gender, educational level, income, health status, and spent time per day, knowledge of schizophrenia, culture, and coping; 2) patient‟s factors included age, clinical symptoms, and disability in daily life; 3) environmental factors included mental health service and social support.Conclusion: Definition of burden have quite same meaning and mostly factors focus on the patient‟s symptoms, demographic factors of caregiver, and time spent per day. Most of studies cannot be generalized due to small sample used in the study and that too conducted in western countries. For further research, the correlation between burden and resources of family caregiver should be investigated particularly in eastern country

Mental disorder and caregiver burden in spouses: the Nord-Trøndelag health study

<p>Abstract</p> <p>Background</p> <p>Researchers generally agree that mental disorder represents a burden to the family. The present study concerns the subjective burden of living with a person with mental disorder, more specifically the association between mental disorder in the index person and subjective well-being and symptoms of anxiety and depression in the spouse.</p> <p>Methods</p> <p>Data were obtained from questionnaires administered to the adult population of Nord-Trøndelag County, Norway during the period 1995-1997. The present study is based on a subsample where 9,740 couples were identified. Subjective burden in spouses of persons with mental disorder was compared with subjective burden in spouses of persons without mental disorder, using analysis of variance (ANOVA). All analyses were stratified by sex.</p> <p>Results</p> <p>Adjusting for several covariates, spouses of persons with mental disorder scored significantly lower on subjective well-being and significantly higher on symptoms of anxiety and depression compared to spouses of index persons without mental disorder. Although highly significant, the effect sizes were moderate, corresponding to a difference in standard deviations ranging from .34 - .51.</p> <p>Conclusions</p> <p>Our study supports the notion that there is an association between mental disorder in one partner and subjective burden in the spouse, but not to the same extent that have been reported in earlier studies, as our results do not indicate that a large proportion of the spouses reach a symptom level of anxiety and depression that reflects clinical mental disorder.</p