Caregiving

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  • 文章类型: Journal Article
    背景:虽然文献强调了照顾家庭成员的巨大挑战,目前尚不清楚智力残疾和具有挑战性行为的家庭照顾者的需求是什么,以及对他们有什么好处。这项研究旨在研究60名父母和兄弟姐妹在管理成年家庭成员在家中生活时具有智力障碍的挑战性行为方面的经验。
    方法:将采用半结构化访谈的定性扎根理论方法。目的抽样将用于招募与智障成年人生活在一起并在香港使用一项社区服务的家庭照顾者。将接触来自中国北方的三所智力残疾人特殊学校。
    结果:本研究旨在深入了解家庭照顾者的经历,并比较他们在家庭中处理智障成年亲属的挑战性行为时所面临的不同情况。
    结论:尽管这项研究针对的是有智力障碍的成年人,研究结果将为表现出苛刻和挑战行为并与家人生活在一起的青少年和年轻人提供参考。建议可以指导制定适当的战略,以加强对家庭照顾者的服务。
    BACKGROUND: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to examine 60 parents\' and siblings\' experiences in managing the challenging behaviours of their adult family member with intellectual disability whilst living at home.
    METHODS: A qualitative grounded theory approach using semi-structured interviews will be adopted. Purposive sampling will be used to recruit family carers who live with adult persons with intellectual disability and use one community service in Hong Kong. Three special schools for persons with intellectual disability from northern China will be approached.
    RESULTS: This study will aim to provide an in-depth understanding of the experiences of family carers and compare the different circumstances they face when managing the challenging behaviours of their adult relatives with intellectual disability in their family home.
    CONCLUSIONS: Although this study targets adults with intellectual disability, the findings will provide a point of reference for adolescents and younger persons who exhibit demanding and challenging behaviours and live with their families. Recommendations can guide the development of appropriate strategies to strengthen services for family carers.
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  • 文章类型: Journal Article
    随着慢性病和残疾人人数的增加,作为照顾者的家庭成员数量也在增加。尽管近年来关注护理,对年轻人的照顾知之甚少,特别是它的全球流行。信息的缺乏对卫生政策和管理有重要影响,导致无法形成适当的循证政策和管理决策。本研究旨在通过对现有文献的系统回顾,对年轻人中护理的患病率进行估计。这项研究的结果表明,年轻青少年的护理患病率在1.1%(1.06-1.14%)和12.0%(11.02-12.98%)之间。然而,对护理的评估因研究而异,都是在发达国家进行的。这些结果提供了有关年轻人照顾负担的信息,并揭示了缺乏全球信息,呼吁对这一特定人群进行更多研究和关注。
    With the increasing number of people with chronic diseases and disabilities, the number of family members as caregivers have also been growing. Despite the attention paid to caregiving in recent years, little is known about caregiving among young people, particularly its global prevalence. The lack of information has important implications for health policy and management, resulting in the inability to form appropriate evidence-based policies and managerial decision making. This study aims to derive an estimate of the prevalence of caregiving among young people through a systematic review of the current literature. The results of this study revealed a prevalence of caregiving among younger adolescents of between 1.1% (1.06-1.14%) and 12.0% (11.02-12.98%). However, the assessment of caregiving varies across studies, and all were conducted in developed countries. These results provide information on the burden of caregiving in young people and reveal the lack of global information, calling for more research on and attention to this specific population.
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  • 文章类型: Journal Article
    背景:移民照顾者支持老龄人口,然而,他们自己的需求往往被忽视。移动技术促进的干预措施可以通过提供易于获取的自我护理材料来促进护理人员的健康。
    目的:本研究采用了一种设计思维框架来研究中国移民照顾者(CIC)未满足的自我护理需求,并共同设计了一个促进与CIC合作的自我护理的应用程序。
    方法:在概念设计和原型共同设计阶段进行了19次半结构化访谈。
    结果:参与者报告说,受心理和社会障碍的影响,自我护理需求未得到满足,移民身份,和照顾任务。他们表示需要学会与护理接受者保持健康的界限,并应对紧急情况。获得知识是drewCICs对使用自我护理应用程序感兴趣的主要好处。然而,使用的潜在障碍包括课程设计问题,技术焦虑,有限的自由时间,和照顾的负担。
    结论:共同设计过程似乎有利于让参与者表达障碍和偏好。
    BACKGROUND: Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials.
    OBJECTIVE: This study employed a design thinking framework to examine Chinese immigrant caregivers\' (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs.
    METHODS: Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases.
    RESULTS: Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs\' interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens.
    CONCLUSIONS: The co-design process appears to be beneficial in having participants voice both barriers and preferences.
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  • 文章类型: Journal Article
    中国老年人群的增加和老年疾病谱的变化导致中国社会对更多老年成人护理的需求不断增长。相关研究表明,与不同家庭成员的生活安排对老年人的健康有不同的影响。本研究采用衰弱指数作为统一的衡量标准来评估整体健康水平,将具体的“法律关系”纳入关于老年人生活安排和健康的研究。
    本研究使用了2016-2018年中国纵向老龄化社会调查的数据。使用OLS和分位数回归来调查法律与老年人健康的关系,以及这种影响在具有不同体弱水平的老年人中是否均匀。该研究使用滞后模型和倾向得分匹配来补偿潜在的内生性担忧。
    研究发现,与daughter妇(20.22%)居住与虚弱指数呈显着正相关(β=0.0088,P<0.001),这表明公婆和媳妇之间的关系会影响老年人的健康。这种影响是非线性和非均匀的老年人有不同程度的脆弱,表现出近似递减然后递增的U形分布,这表示具有不同健康状况的老年人对代际护理有不同的需求。此外,这种影响在不同性别的老年成年人群体中有所不同,城市和农村地区,和年龄组。
    这项研究调查了生活安排中的“法律关系”对老年人健康的影响。它表明与daughter妇共同居住对老年人的健康有不利影响。因此,研究表明,当老年人的健康和经济条件允许时,可以考虑与他们的孩子“住得近但不和”的生活安排。
    UNASSIGNED: The increasing geriatric population and variation in the disease spectrum among older adults in China contribute to a growing demand for more aged adult care in Chinese society. Relevant studies have shown that living arrangements with various family members have variable impacts on the older adult\'s health. This study employs the Frailty Index as a unified measurement standard to assess the overall health levels, integrating the specific \"in-law relationships\" into the research on living arrangements and the health of older adults.
    UNASSIGNED: This study used data from the China Longitudinal Aging Social Survey 2016-2018. OLS and Quantile Regression were used to investigate the in-law relationship on older adult health and whether this impact is homogeneous across older individuals with varying infirmity levels. The study used a lag model and propensity score matching to compensate for potential endogeneity concerns.
    UNASSIGNED: The study found that residing with a daughter-in-law (20.22%) had a significant positive correlation with the frailty index (β=0.0088, P<0.001), indicating that the relationship between parents-in-law and daughters-in-law can influence the health of the older adult. This impact is nonlinear and non-homogeneous for older adult people with various levels of frailty, exhibiting an approximately decreasing and then increasing U-shaped distribution, which denotes that older adult people with different health conditions have distinct demands for intergenerational care. In addition, this impact varies among older adult groups of disparate genders, urban and rural areas, and age groups.
    UNASSIGNED: This study investigates the impact of \"in-law relationships\" within living arrangements on the health of older adults. It shows that co-residing with a daughter-in-law has adverse effects on the health of older adults. Therefore, the study suggests that when the health and economic conditions of the elderly permit, a \"live-near-but-not-with\" living arrangement with their children can be considered.
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  • 文章类型: Journal Article
    对于社交网络是否以及为什么保护非正式护理人员的心理健康知之甚少。这项研究探讨了非正式照顾者社交网络类型与抑郁症状之间的关系以及心理弹性的中介机制。潜在的类分析,应用于278名新加坡护理人员的横截面数据,确定了四种社交网络类型:受限制(42%),朋友(16%)家庭(21%),多样(21%)。路径分析表明,社会网络类型多样化,与受限制的社交网络类型相比,与较低水平的抑郁症状有关,心理弹性完全介导了这种联系。干预措施应帮助护理人员与家人和朋友保持社交网络。
    使用新加坡的数据探索了非正式照顾者社交网络类型。多样化,朋友,家庭,并确定了受限制的社交网络类型。不同的社交网络类型与抑郁症状呈负相关。心理弹性完全介导了这种关联。
    Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.
    Informal caregiver social network typologies were explored using data from Singapore.Diverse, friend, family, and restricted social network types were identified.Diverse social network type was negatively associated with depressive symptoms.Psychological resilience fully mediated the association.
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  • 文章类型: Journal Article
    背景:文化敏感的护理实践尚未将孝道作为一种文化价值和立场,与美国老龄化的华裔和华裔美国人(CCA)家庭中的照料有关,然而,这对CCA中的健康老龄化至关重要。
    目的:在照顾老化的CCA时了解孝道,并概念化可操作的定义和框架。
    方法:在CINAHL中进行了系统搜索,PubMed,Scopus,和PsycINFO数据库。使用Walker和Avant的方法对CCAs中的孝道概念进行分析。在最终的全文分析中选择了26项研究。
    结果:综合证据确定了四个前提:(a)孝道义务作为“文化基因”,(b)利他主义意识,(c)家庭团结,和(D)对“出生权”的社会期望。属性包括家庭材料和情感支持,服从,虔诚的崇敬,和社会规范。后果与照顾者的负担有关,心理和身体健康,生活质量,和健康公平。
    结论:孝道是支持年迈父母的内在愿望,也是坚持中国社会道德原则的外在愿望。拟议的操作框架“为美国老龄化的CCA提供照顾”值得进一步研究。
    BACKGROUND: The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs.
    OBJECTIVE: To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework.
    METHODS: A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant\'s methods. Twenty-six studies were selected in the final full-text analysis.
    RESULTS: Synthesis of evidence identified four antecedents: (a) filial obligation as a \'cultural gene\', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of \'birth right\'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity.
    CONCLUSIONS: Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework \"Caregiving for aging CCAs in the United States\" merits further study.
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  • 文章类型: Journal Article
    背景:在2015年至2020年期间,美国的护理患病率从16.6%增加到19.2%。看护者在大流行后以及随着人口老龄化而发挥着至关重要的公共卫生作用。然而,照顾可能不利于照顾者的健康。许多研究表明,沟通和联系是照顾者健康干预的有效形式,但是如何实现这一点需要进一步的调查。
    目的:本研究旨在探讨护理对心理困扰导致的饮酒问题的间接影响。此外,本研究旨在提供初步证据,证明线上和线下沟通和联系对护理人员幸福感的不同影响.
    方法:通过检查对2020年健康信息国家趋势调查(n=3,865)的响应来评估预测。进行了中介分析,以测试心理困扰对护理与饮酒之间关系的中介作用。进行了二级适度分析。在线交流和联系,社交媒体用于健康,和离线类型,婚姻或浪漫的伙伴关系,被测试为主持人,以减轻护理的心理困扰。
    结果:确定了竞争性调解。我们发现护理对心理困扰介导的饮酒有积极的间接影响(bp=.0017,p<.05),但护理对饮酒有消极的直接影响(bp=-.0340,p<.05)。此外,该研究报告了适度适度对护理与心理困扰之间的联系产生了强烈的积极影响。在较少使用社交媒体的人中,护理对精神困扰的负面影响更大,特别是那些没有浪漫或婚姻伴侣的人。
    结论:研究结果表明,照顾者经历更多的精神困扰,这导致了危险的行为。这项研究强调了在线和离线联系在减轻护理不利后果方面的关键作用。
    BACKGROUND: The prevalence of caregiving in the United States has increased from 16.6% to 19.2% during the period between 2015 and 2020. Caregivers play a critical public health role post-pandemic and as the population ages. However, caregiving can be detrimental to the health of caregivers. Many studies have shown that communication and connectedness are effective forms of health intervention for caregivers, but how this can be achieved requires further investigation.
    OBJECTIVE: This study aimed to investigate the indirect effect of caregiving on problems of alcohol drinking through psychological distress. Moreover, this study aimed to provide initial evidence of the distinct effects of online and offline communication and connectedness on caregivers\' well-being.
    METHODS: The predictions were evaluated by examining responses to the Health Information National Trends Survey 2020 (n = 3,865). A mediation analysis was conducted to test the mediating effect of psychological distress on the association between caregiving and alcohol drinking. A second-level moderation analysis was performed. The online communication and connectedness, social media use for health, and the offline type, marital or romantic partnership, were tested as moderators to lessen the psychological distress of caregiving.
    RESULTS: A competitive mediation was identified. We found a positive indirect effect from caregiving to alcohol drinking mediated by psychological distress (bp = .0017, p < .05) but a negative direct effect from caregiving to alcohol drinking (bp = -.0340, p < .05). Furthermore, the study reported a strongly positive effect of moderated moderation on the linkage from caregiving to psychological distress. The negative impact of caregiving on mental distress was greater among those who used social media less, particularly those without a romantic or marital partner.
    CONCLUSIONS: The findings indicate that caregivers experience more mental distress, which leads to risky behavior. This study highlights the crucial role of both online and offline connectedness in mitigating the adverse consequences of caregiving.
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  • 文章类型: Journal Article
    Background: Employing non-family paid helpers has become a prevalent practice across North America, Europe, and Asia, which families adopt to alleviate the stroke care burden, allowing family to take a break from their obligations and perform other social activities. However, paid helpers\' experiences of providing palliative care to stroke patients are under-explored. This study aimed to explore the caregiving experiences of non-family paid helpers providing palliative care to stroke patients. Method: A qualitative descriptive study was undertaken using purposive sampling and semi-structured individual in-depth interviews. Thematic analysis was used for data analysis. Results: Seventeen participants (mean age: 51.23 years) were included, predominantly being female (88%), and their caregiving experiences with patients ranged from four to 26 years. Participants shared that monetary compensation offset the exhaustion, familial and health sacrifices of palliative caregiving. They emphasized emotional self-management through accepting and coping or avoiding and distancing, and appreciated rewarding appraisals from stroke patients and family members. They also expressed a lack of recognition from the public, being invisible to the healthcare system/professionals, and insecurity in employment rights. Conclusions: Findings support the need for governmental initiatives to subsidize families in employing helpers to provide palliative care. Helpers perceived monetary compensation and a reciprocal caregiving relationship as the primary motives for providing care. Public recognition of this role as a helper in caregiving, contractual employment rights, and being recognized by the healthcare system and healthcare professionals are considerations in promoting quality care and alleviating a health care burden. The findings may contribute to further understanding of the experiences of non-family paid helpers in a job lacking recognition when delivering palliative care in a hospital for stroke patients. Evidence-based interventions that enhance reciprocity and recognition should be considered as part of the global initiatives to support paid helpers in palliative care.
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  • 文章类型: Journal Article
    由于护理承诺,老年人的照顾者可能没有时间利用白天提供的现场社区服务。在先进技术的支持下,远程护理可能是一个方便和容易进入的渠道,为护理人员提供个性化的护理建议。
    该研究的目的是描述一项研究方案,该方案强调了基于远程护理的干预计划的开发,以降低社区居住的老年人的非正式护理人员的压力水平。
    这是一项随机对照试验。该研究得到了两个社区中心的支持。研究参与者将被随机分配到基于远程护理的干预组或对照组。前者将接受为期3个月的计划,包括三个部分:由健康和社会护理团队支持的在线护士病例管理,在线资源中心,和讨论论坛。后者将获得社区中心提供的常规服务。将在两个时间点收集数据-干预前(T1)和干预后(T2)。主要结果是压力水平,次要结果包括自我效能感,抑郁程度,生活质量,和照顾的负担。
    除了照顾一个或多个老年人,非正式的照顾者必须处理工作,家务,照顾他们的孩子.这项研究将为知识差距增加有价值的信息,即在综合健康社会团队的支持下,基于远程护理的干预措施是否可以减轻社区居住老年人的非正式护理人员的压力水平。如果成功,政策制定者和医疗保健专业人员应考虑将远程医疗模式纳入初级健康环境,以便非正式护理人员与他们对应,减轻他们的照顾压力,促进健康生活。
    https://www.clinicaltrials.gov/,NCT05636982。
    UNASSIGNED: Due to caregiving commitments, caregivers of older adults may not have the time to make use of the onsite community services available to them during the day. With the support of advanced technology, telecare could be a convenient and easily accessible channel for providing individualized caregiving advice to caregivers.
    UNASSIGNED: The aim of the study is to describe a research protocol that highlights the development of a telecare-based intervention program for reducing stress levels in informal caregivers of community-dwelling older adults.
    UNASSIGNED: It is a randomized controlled trial. The study is supported by two community centers. The study participants will be randomly assigned to either the telecare-based intervention group or the control group. The former will receive a 3-month program comprised of three components: online nurse case management supported by a health and social care team, an online resource center, and a discussion forum. The latter will receive the usual services that provided by the community centers. Data will be collected at two time points - pre-intervention (T1) and post-intervention (T2). The primary outcome is stress levels, while secondary outcomes include self-efficacy, depression levels, quality of life, and caregiving burden.
    UNASSIGNED: Besides taking care of one or more older adults, informal caregivers have to deal with work, chores, and take care of their children. This study will add valuable information to the knowledge gap on whether telecare-based interventions with the support of an integrated health-social team can alleviate the stress levels of informal caregivers of community-dwelling older adults. If successful, policymakers and healthcare professionals should consider incorporating telecare modalities in a primary health setting for informal caregivers to correspond with them, to relieve their caregiving stress and promote a healthy life.
    UNASSIGNED: https://www.clinicaltrials.gov/, NCT05636982.
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  • 文章类型: Journal Article
    儿童功能性便秘是一个世界性问题,影响儿童的肠道功能及其家庭的生活质量。这种疾病的治疗和管理需要由父母在家进行。评估护理需求是计划和实施干预措施的重要环节。这项研究旨在评估FC婴幼儿父母的护理需求。
    研究人员从一家儿童医疗中心的门诊儿科便秘诊所招募了父母的便利样本。总共招募了211名父亲/母亲。护理需求通过问卷调查来衡量,使用多元回归分析检查了护理需求与潜在因素之间的关联。
    绝大多数参与者(88.7%)表示需要得到专业人士的支持,只有44人(20.85%)获得了医务人员的帮助。家长的需求主要包括信息需求,健康需求,心理需求,和社会需求。在所有的需求中,最高分是信息需求(3.87±0.69),其次是健康需求维度(3.74±0.82)。结果显示父母教育差异有统计学意义,居住地,孩子的年龄,FC的持续时间,排便频率,排便困难,护理需求中的大便性状(p<0.05)。回归模型解释了64.2%的护理需求变化。
    信息需求是父母的主要关注点,在治疗和护理期间,应解决父母未满足的需求。在制定护理计划和提供健康教育时,应根据孩子和父母的具体情况进行调整,以提高父母对治疗和护理的依从性。
    UNASSIGNED: Childhood functional constipation is a worldwide problem that affects the intestinal function of children and the quality of life of their families. Treatment and management of the disease need to be carried out at home by parents. Assessment of caregiving needs is an important link in planning and implementing the intervention. This study aimed to assess the caregiving needs of parents of FC infants and toddlers.
    UNASSIGNED: The researchers recruited convenience samples of parents from an outpatient pediatric constipation clinic of a children\'s medical center. Totally 211 fathers/mothers were recruited. Nursing needs were measured by a questionnaire, and associations between nursing needs and potential factors were examined using multiple regression analysis.
    UNASSIGNED: The vast majority of participants (88.7%) expressed the need of receiving support from professionals, and only 44 (20.85%) had obtained help from medical staff. The needs of parents mainly include information needs, health needs, psychological needs, and social needs. Of all the needs, the highest score was for information needs (3.87 ± 0.69), followed by the dimension of health needs (3.74 ± 0.82). Results showed statistically significant differences in parental education, place of residence, age of children, duration of FC, defecation frequency, difficulty of defecation, and stool traits in nursing needs (p < 0.05). The regression model explained 64.2% of the variance of nursing needs.
    UNASSIGNED: Information needs were the major concern for parents, and the unmet needs of parents should be addressed during treatment and care. When developing care plans and providing health education, it should be adjusted according to the specific conditions of the child and parents to improve the compliance of the parents with treatment and care.
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