BACKGROUND: Cancer-related pain is a global health-related problem associated with functional impairment, anxiety, depression, and reduced quality of life. The use of educational interventions for patients and their caregivers has been proposed as a promising tool for overcoming pain in cancer. The aim of this study was to summarize by means of a standardized methodological systematic revision the actual pain education intervention used in cancer patients and their caregivers and to analyze its effects on pain.
METHODS: A search was conducted through PubMed, Web of Science, Scopus and Cinhal from their inception to September 2022. Randomized controlled trials which included pain education interventions were identified. Two reviewers performed independent data extraction and methodologic quality assessments of these studies.
RESULTS: A total of seven studies was included in the study. The meta-analysis showed that pain education interventions have a significant effect on the worst pain; however, there was no effect on average pain.
CONCLUSIONS: Pain education interventions addressed to patients and their caregivers could have positive effects on cancer-related pain. It is recommended that a minimum of three sessions of about one hour\'s duration be held once a week. Further research needs to be carried out and analyzed on the effects over the long term. Pain education interventions show positive results in improving pain in cancer patients regardless of etiology or extent of the cancer. Studies with better methodological quality should be carried out to address specific components related to education interventions.

OBJECTIVE: To synthesize the experiences of children and parents/caregivers in the process of pediatric home hospitalization (PHH).
BACKGROUND: The practice of home hospitalization (HH), while not a new concept has expanded in recent years. This model of care consists of continuous care at home for children with acute illness or acute chronic disease and presents itself as an alternative to conventional hospitalization (Middel, 2007; Parab et al., 2013). Excellence in pediatric healthcare is fundamental and this review provides a necessary understanding towards the experiences of children and their families in HH.
METHODS: Research was carried out in three phases and included both published and grey literature in the CINAHL, MEDLINE, MedicLatina, PubMed, Cochrane Library, Psychology and Behavioral Sciences Collection, and OpenAIRE databases to find relevant articles. Studies published in Portuguese, English, Spanish, and French with no time limit were considered.
RESULTS: Findings were aggregated into five categories: communication and care experiences, parental dynamics and role carers, benefits and challenges for parents and children, relationship between parents, children\'s, and healthcare professionals and enhancing continuity of care and family support. According to ConQual the confidence level of the results was moderate in all articles.
CONCLUSIONS: Through PHH, it is possible to avoid the impact of a conventional hospitalization since it promotes family union, increases the affective bond, the feeling of security, comfort, tranquillity, relief, confidence, and autonomy, reducing stressors such as anxiety, fear, nervousness, uncertainty, and fear.

OBJECTIVE: To describe the prevalence and associated factors of mental health problems in secondary school-aged (11-16 years) children with epilepsy and their primary caregivers compared to a control group without epilepsy.
METHODS: Children with epilepsy (n = 60), controls (n = 49), and caregivers (n = 60 epilepsy and n = 49 control group) completed a measure of the child\'s mental health (Strengths and Difficulties Questionnaire; SDQ). Primary caregivers in both groups completed a measure of their own mental health (Depression, Anxiety, and Stress Scale-21; DASS-21). Factors associated with child and caregiver mental health in the epilepsy group were explored using linear regression.
RESULTS: There were no significant differences between the epilepsy and control group regarding age, gender, ethnicity and socioeconomic status. A higher proportion of children with epilepsy scored in the at-risk range on the SDQ indicating more mental health problems than the control group, as reported by the children (45% vs. 24 %) (p = 0.026) and caregivers (52% vs. 14 %) (p < 0.001). Primary caregivers of children with epilepsy had more symptoms of depression (p = 0.001), anxiety (p = 0.028) and stress (p = 0.019) than caregivers in the control group. Children with epilepsy with greater motor coordination problems had greater mental health difficulties. Children with epilepsy with more mental health difficulties had caregivers with more difficulties and caregivers of children with earlier onset of seizures had more mental health difficulties.
CONCLUSIONS: Epilepsy confers a high risk for mental health problems in adolescents and their primary caregivers. There is a need to better understand the relationship between caregiver and child mental health difficulties in epilepsy.

UNASSIGNED: Fetal alcohol spectrum disorder (FASD) is a common developmental disability that requires lifelong and ongoing support but is often difficult to find due to the lack of trained professionals, funding, and support available. Technology could provide cost-effective, accessible, and effective support to those living with FASD and their caregivers.
UNASSIGNED: In this review, we aimed to explore the use of technology available for supporting people living with FASD and their caregivers.
UNASSIGNED: We conducted a scoping review to identify studies that included technology for people with FASD or their caregivers; focused on FASD; used an empirical study design; were published since 2005; and used technology for assessment, diagnosis, monitoring, or support for people with FASD. We searched MEDLINE, Web of Science, Scopus, Embase, APA PsycINFO, ACM Digital Library, JMIR Publications journals, the Cochrane Library, EBSCOhost, IEEE, study references, and gray literature to find studies. Searches were conducted in November 2022 and updated in January 2024. Two reviewers (CZC and HW) independently completed study selection and data extraction.
UNASSIGNED: In total, 17 studies exploring technology available for people with FASD showed that technology could be effective at teaching skills, supporting caregivers, and helping people with FASD develop skills.
UNASSIGNED: Technology could provide support for people affected by FASD; however, currently there is limited technology available, and the potential benefits are largely unexplored.

BACKGROUND: The onset of psychosis brings unfamiliar experiences that can be disturbing for patients and their caregivers. Few studies from India (only one from North India) have examined these experiences from the perspective of the patient and caregiver. We explored experiences of first episode psychosis (FEP) patients and their caregivers within a North Indian context.
METHODS: Semi-structured interviews were conducted in 2019 with ten FEP patients and their caregivers (total n=20) receiving out-patient care in a tertiary care centre. Topic guides focused on concerns/complaints, symptoms, help-seeking, and barriers and facilitators to treatment. Interviews were audio recorded, transcribed, and analysed using qualitative content analysis.
RESULTS: Main categories of responses from patients and caregivers included: initial complaints for seeking help, initial emotional response, barriers to seeking treatment, perceived dysfunction and improvement, experienced stigma, understanding about illness, early follow-up, preventive measures and awareness programs. Caregivers undergo myriad of emotional reactions including anger, anxiety, guilt, and confusion. Symptoms other than psychotic symptoms were the primary complaint upon seeking help, and there was lack of understanding about the psychosocial model of care (role of medications acknowledged with little awareness regarding psychosocial interventions in recovery). Persisting occupational dysfunction despite perceived symptomatic improvement was described by both patients and caregivers.
CONCLUSIONS: North Indian patients with FEP lack awareness of symptoms. Therefore, onus for seeking help often falls on their caregivers. Psychoeducation from first contact with services and increasing awareness about psychotic illness within the community might help address lack of awareness about symptoms, mental health services, early signs of relapse, and importance of psychosocial interventions in achieving functional recovery.

Previous work has shown that caregiver attention shapes visual cognition in infants through dyadic interactions. Is this association measurable when visual cognition is objectively measured in caregivers and infants using comparable experimental paradigms? In the current study, we presented infants (N = 86) and caregivers (N = 78) with age-specific variants of the same preferential looking visual cognition task to investigate whether caregiver visual cognition was associated with their infants\' visual cognition. In each trial of the task, two side-by-side flashing displays of coloured shapes were presented. On the \'unchanging\' side, the colours of the shapes remained the same. On the \'changing\' side, the colour of one shape changed after each flash. Load was varied by changing the number of shapes across trials (low, medium, and high loads). We extracted looking dynamics using video recordings and brain function using functional near-infrared spectroscopy as both infants and caregivers engaged with the task. Change preference (CP) score, which represented the amount of time spent looking at the changing side divided by the total looking duration, showed a load-dependent modulation for both infants and caregivers. Both groups showed the highest CP scores at the low load. Further, higher caregiver CP scores was associated with higher infant CP scores at the low load. Both infants and caregivers engaged canonical regions of the fronto-parietal network involved in visual cognition. Critically, higher caregiver CP scores were associated with greater activation in the left superior parietal lobule in younger infants, a region involved in allocating visuo-spatial attention and working memory maintenance. Further, there was spatial overlap between performance-dependent regions in the right parietal cortex in caregivers and younger infants. Our findings provide first evidence of a heritability-related visual neurocognitive association between caregivers and their children in the first year of life.

This study aimed to determine the mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer. This cross-sectional study was conducted on 200 caregivers of children and adolescents with cancer. Adult Hope Scale, Connor-Davidson Resilience Scale, and Depression, Anxiety and Stress (DAS) scales were used for data collection. The mediator and moderator model was tested using the SPSS macro PROCESS (Model 4, and 5). The mediator model (model 4) indicated that DAS significantly correlated with resilience (β = - 0.54, t-value = - 5.01, p < 0.001), and hope (β = - 0.84, t-value = - 3.45, p = 0.0007). Hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = - 0.18, SE = 0.06, 95% CI - 0.33 to - 0.06). The mediator and moderator model (model 5) showed that female caregivers had a stronger correlation between resilience and DAS when compared to their male counterparts (β = - 0.56, t-value = - 3.90, p-value = 0.0001); also, hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = - 0.20, SE = 0.08, 95% CI - 0.37 to - 0.04). In conclusion, hope was a mediator, and female caregivers were a moderator in the relationship of resilience with depression, anxiety, and stress, and its promotion might be effective among caregivers of children and adolescents with cancer. It seems that resilience, female caregivers, and hope may provide good protection against depression, anxiety, and stress in caregivers of cancer patients.

Introduction Pressure ulcers, also known as bedsores, are a significant concern for bedridden individuals, presenting both physical and socioeconomic challenges. Factors such as prolonged immobility, chronic medical conditions, and poor nutrition contribute to their development. Despite extensive research in some regions, studies comparing diabetic and non-diabetic populations remain limited, particularly in low-income settings. This study aimed to investigate the risk factors and frequency of pressure ulcers among bedridden patients, addressing this gap in understanding and guiding targeted interventions. Materials and methods A cross-sectional study was conducted across four government hospitals in Peshawar, Pakistan. A total of 388 bedridden patients with pressure ulcers were included, and data were collected through a questionnaire. The questionnaire covered demographics, comorbidities, duration of bedbound status, BMI, and caregivers\' awareness of pressure ulcer care. Data analysis was performed using SPSS version 22.0 (Armonk, NY: IBM Corp.), with qualitative data presented as frequencies and percentages and quantitative data as mean and standard deviation. Chi-square tests were utilized for significance, with p<0.05 considered significant. Results Of the 388 patients analyzed, 230 (59.3%) were diabetic, highlighting the prevalence of diabetes among pressure ulcer cases. The majority of diabetic patients with ulcers were over 41 years old, and 293 (75.5%) had comorbidities. Surgical intervention was the primary cause of ulcers in 213 (54.8%) cases, followed by stroke in 77 (19.8%) cases. Notably, 252 (65%) of caregivers exhibited inadequate knowledge regarding ulcer care. Stage II ulcers were prevalent in both diabetic and non-diabetic cohorts. Conclusions Pressure ulcers are poorly controlled complications observed in bedridden individuals, highlighting a critical need for comprehensive preventive measures and caregiver education to alleviate the burden of pressure ulcers, especially in diabetic patients. Factors such as prolonged immobility, surgical interventions, and insufficient caregiver knowledge contribute to the development of pressure ulcers. Understanding these complexities is essential for implementing effective care approaches and mitigating the impact of pressure ulcers.

Psychosocial stress may increase ovarian cancer risk and accelerate disease progression. We examined the association between caregiver burden, a common stressor, and risk of epithelial ovarian cancer. We prospectively followed 67,724 women in the Nurses\' Health Study (NHS; 1992-2012) and 70,720 women in the NHSII (2001-2009) who answered questions on informal caregiving (i.e., caregiving outside of work). Women who reported no informal caregiving were considered non-caregivers while, among women who provided care outside of work, caregiver burden was categorized by time spent caregiving and perceived stress from caregiving. For the 34% of women who provided informal care for ≥15 hours per week, 42% described caregiving as moderately to extremely stressful. Pooled multivariate analyses indicated no difference in ovarian cancer risk for women providing ≥15 hours of care per week compared to non-caregivers (hazard ratio (HR)=0.96; 95% confidence interval (CI): 0.79-1.18), and no association was evident for women who reported moderate or extreme stress from caregiving compared to non-caregivers (HR=0.96; 95% CI: 0.75-1.22). Together with prior work evaluating job strain and ovarian cancer risk, our findings suggest that, when evaluating a stressor\'s role in cancer risk, it is critical to consider how the stressor contributes to the overall experience of distress.

We assessed which coping strategies (problem-focused, emotion-focused, dysfunctional) mediate the association between caregivers\' understanding of dementia as terminal and their distress. A total of 215 caregivers of community-dwelling persons with severe dementia were surveyed every 4 months over 3 years. A generalized structural equation model was used to test mediation. Caregivers who correctly understood dementia as terminal and those unsure (vs incorrect), experienced more distress (correct: β [95% confidence interval (CI)]: 0.80 [0.00 to 1.60]; unsure: 0.95 [0.04 to 1.87]). Caregivers with correct understanding of dementia as terminal (vs incorrect) employed more dysfunctional (2.01 [0.60 to 3.42]) and problem-focused coping strategies (2.56 [0.08 to 5.05]). Although dysfunctional and problem-focused coping (associated with higher distress) mediated the positive association between caregivers\' understanding that dementia is terminal and their distress, emotion-focused coping (associated with lower distress) did not offset this relationship. Results suggest that terminal illness disclosure to caregivers should be accompanied by interventions to promote emotion-focused coping strategies. Highlights Caregivers who understood dementia as terminal experienced more distress. Dysfunctional and problem-focused coping mediated the positive relationship between terminal illness understanding and caregiver distress. Emotion-focused coping did not offset this relationship.