Made available in DSpace on 2016-06-02T19:45:57Z (GMT). No. of bitstreams: 1 DissLZMA.pdf: 788184 bytes, checksum: 487fa9a5ccb31dc3ce033b97c8610d15 (MD5) Previous issue date: 2007-06-15 / Universidade Federal de Sao Carlos / Considering the highest increasing of the elderly population in our country and simultaneously the increasing of morbidity rate of chronic-degenerative disease, in general, there are people seeking to be in attendance, at day centre or hospital; these people are dependents on and when come back home, need familial caregivers. The caregivers are the fundamental importance to keep the patient in his community, to prevent and treat the problems caused by the stress factors among them must contribute to reduce or to postpone the hospitalization of caregivers. Besides, the improvement on quality of life could give the caregivers do better help to patients by influencing positively on the chronic disease course. So, this research try to undestand the reality of the caregivers lifes who s relatives are chronic illnesses pacientes. With this knowlege, implement and evaluate the effectiveness of an intervention proposal with caregivers. The objective of this intervention is to attenuate the happened stress conditions of the care activities. The research will use interview with caregivers at USE, at Federal University at S.Carlos; this interview will be taped and latter, a transcription to analyze the content of answers and to elaborate the intervention plan, in that case, a course. The course will consist of informative aspect about disease and daily life activities, as well as, formative aspect about self knowledge. A quality of life instrument named Caregiver Burden Scale will be given to caregivers. After the intervention (course) the Scale will be give once more to verify the date and to check the efficacy of intervention. / Intervenção: suporte para cuidadores de doentes crônicos através do ensino. Considerando-se o acelerado aumento da população idosa em nosso país e simultaneamente o aumento do índice de morbidade de doenças crônico-degenerativas em geral, temos observado cada vez mais o aumento do número de pessoas buscando atendimento, tanto em nível ambulatorial quanto hospitalar, estas pessoas são muitas vezes dependentes e quando retornam para suas casas precisam receber cuidados de algum membro da família, o cuidador. Sendo os cuidadores de fundamental importância para manter o paciente na comunidade, a prevenção e o tratamento dos problemas (produzidos pelo impacto de fatores estressantes) entre os cuidadores podem contribuir para se reduzir ou protelar a institucionalização. Além do mais, a melhora na qualidade de vida dos cuidadores possibilita-lhes prestar melhor assistência aos pacientes, influenciando positivamente o curso da doença crônica. Assim, esta pesquisa tem como objetivo identificar a realidade de cuidadores de pacientes portadores de doenças crônicas e, a partir deste reconhecimento, implementar e avaliar a eficácia de uma proposta de intervenção junto a cuidadores que objetiva atenuar as condições estressantes advindas das práticas de cuidado. Utilizará para tanto, entrevistas com cuidadores familiares, abordados em uma Unidade Saúde Escola (USE), estas entrevistas serão gravadas e posteriormente transcritas para análise do conteúdo e elaboração da intervenção, no caso um curso, onde serão abordados aspectos informativos sobre a patologia e as atividades desempenhadas no cotidiano, assim como, aspectos formativos como o autoconhecimento; também nesta primeira fase será aplicado um instrumento de qualidade de vida denominado Caregiver Burden Scale. Após a intervenção o instrumento será aplicado novamente para ser possível um confronto de dados e verificar a eficiência da intervenção.

Caring for a family member who is ill can be a draining experience (Cooper et al., 2006; Daire, 2002; Zarit et al, 1980). Providing care for a family member that is living with HIV/AIDS is potentially even more stressful because of social meanings associated with HIV/AIDS infection (Stajduhar, 1998) and the contagious nature of the HIV virus (Powell-Cope & Brown, 1992). Research indicates that most caregivers are female (Bunting, 2001; Songwathana, 2000). In Africa women bear the brunt of the burden of providing care for family members who are living with HIV/AIDS (Mushonga, 2001; Olenja, 1999). This study examined coping factors and caregiver burden among female caregivers (N=116) of a family member living with HIV/AIDS in Kenya. Coping factors were derived from a principal components factor analysis of the fourteen scales on the Brief Cope (Carver, 1997). Caregiver burden was measured using the Zarit Caregiver Burden Inventory. Multiple regression analysis was used to investigate the relationships between caregiver burden and coping factors. Post–hoc multiple regression analyses further investigated the relationship between caregiver burden and caregiver demographic characteristics. The relationship between caregiver burden and care recipient characteristics was also investigated. The principle components factor analysis of the Brief Cope yielded five coping factors that were labeled: Social support, Hope, Acceptance, Planning, and Disposition. The regression analysis that was conducted to investigate the relationships between these five coping factors and caregiver burden indicated a significant inverse relationship between Hope and caregiver burden. The post-hoc analyses investigating the relationship between various caregiver and care recipient characteristics indicated a significant relationship between the caregiver's age and caregiver burden, and education level and caregiver burden. An increase in age correlated with a decrease in caregiver burden. An increase in education level correlated with reduced caregiver burden. Implications of the findings for research and practice are discussed.

A qualitative study was conducted to explore and describe the knowledge and perceptions of parents and caregivers on the causes of diarrhoea among children under five years living in the rural areas of the Eastern Cape Province, South Africa. The aim was to assist in correcting the negative perceptions of the causes of under five child diarrhoea through improved educational interventions. Data were collected through individual, semi-structured and face-to-face interviews from seven participants who were parents and caregivers of under-five children presenting with diarrhoea or admitted for the management of diarrhoea at a specific hospital and thematic analysis was done. The findings revealed that the participants had inadequate knowledge and lacked understanding of diarrhoea and its causes. Participants could not mention all the causes and risk factors associated with diarrhoea. Noteworthy is that the participants’ perceived diarrhoea as a serious condition. The study recommends that the implementation of policies regarding public education and health promotion programmes be targeted at educating parents and caregivers / Health Studies / M.A. (Public Health)

Abstrakt Bakgrund: 2010 avled omkring 72 000 människor med behov av palliativ vård i Sverige. Sedan ÄDEL-reformens genomförande har andelen svårt sjuka som vårdas och dör i hemmet ökat. Den avancerade medicinska hjälpen i hemmet har förbättrats, men anhöriga spelar fortfarande en viktig roll för genomförandet av palliativ vård i hemmet. Syfte: Litteraturstudiens syfte var att studera anhörigas upplevelser vid vård av en närstående i hemmet i livets slutskede. Metod: Studien genomfördes som en litteraturöversikt. Sju artiklar med kvalitativ design och en artikel med mixed design valdes ut genom sökning i databaserna CINAHL, PubMed och PsycINFO. Artiklarna kvalitetsgranskades och analyserades sedan med hjälp av kvalitativ manifest innehållsanalys. Resultat: Majoriteten av anhörigvårdarna var kvinnor. Resultatet visade i hög grad på att anhörigvårdare upplevde vårdandet av sin närstående svårt och påfrestande. Problem som nämns i resultatet är bland annat trötthet, oro och ångest, frustration, ilska och rädsla. Positiva aspekter framkom också och däribland uppgavs tillfredsställelse, stolthet och en känsla av att ha gjort det rätta. Konklusion: Anhörigvårdarna ses som en förutsättning för palliativ vård i hemmet. Bättre stöd och mer information från sjuksköterskan och övrig personal i teamet till anhöriga som vårdar en familjemedlem i hemmet i livets slutskede kan leda till ökad trygghet och delaktighet hos anhörigvårdarna. Forskningsmässigt är ämnet väl studerat, men kunskapen skulle behöva spridas till yrkesverksamma inom sjukvården.

The occurrence of custodial grandparents is increasing greatly. These grandparents face added stress and many adversities that arise from caregiving. Findings of current research tends to be mixed on the effects of grandparents raising grandchildren experience. Much research concludes that grandparent caregivers experience negative declines in overall health and well-being, while other research points out that the caregiving role may actually be a positive experience for the grandparent. The current study hypothesizes that mixed research may be a result of varying levels of resilience in the custodial grandparent population. The model proposed in this study looks at resilience as a mediator between several variables that effect custodial grandparenting. The current sample consisted of 239 custodial grandparents. A regression/correlation analysis was conducted on the data, and it was found that resilience levels were significant in mediating the effects of grandparent caregiving.

This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members and staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm. A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. Talk about dependence on culture underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.

Introduction: Les aidants des personnes âgées (PA) atteintes de la démence de type Alzheimer (DTA) sont confrontés à de nombreux défis lors du soin de leurs proches, y compris ceux liés à l’alimentation. Cependant, ces défis restent méconnus et les stratégies créées pour les gérer sont encore peu efficaces. Objectifs: Identifier les difficultés rencontrées par les aidants pendant la gestion de l’alimentation des PA atteintes de la DTA ayant participé à une intervention nutritionnelle (l’étude NIS) et dégager leurs opinions concernant cette intervention. Sujets: Trente-trois aidants des PA avec DTA du groupe intervention de l’étude NIS ont été ciblés. Méthodes: L’approche qualitative a été employée lors des entrevues individuelles auprès de ces aidants. Les entrevues ont été transcrites et le verbatim fut soumis à une analyse thématique. Résultats: Vingt-quatre aidants ont été interviewés. Quelque 58,4 % avaient 70 ans et plus et 58,3 % étaient des conjoint (es) des patients affectés. Quatre catégories de thèmes furent dégagées menant à l’identification des défis alimentaires suivants: les changements des habitudes alimentaires (altération des préférences); les perturbations du comportement alimentaire (ex. l’oubli de repas); la dépendance à la préparation des repas. L’utilité des conseils, la gentillesse et la compétence du personnel NIS, la documentation écrite offerte et la durée du suivi ont été appréciées par les aidants. Conclusion: Une meilleure compréhension de l'expérience de soin vécu par l’aidant est essentielle au développement des interventions nutritionnelles adaptées aux besoins des aidants et des PA atteintes de la DTA. / Introduction: Caregivers of older adults suffering from Alzheimer disease (AD) are confronted by many challenges related to the care of their family members, including dietary management. However these challenges remain poorly understood by health professionals and strategies for managing these challenges are still not very effective. Objectives: To identify difficulties encountered by caregivers related to dietary management of their family members with AD taking part in a nutritional intervention (NIS study), and to gather their opinions about this intervention. Subjects: Thirty-three caregivers of older adults with AD were targeted from the NIS study intervention group. Methods: Using a qualitative approach, individual interviews were conducted with these caregivers, the verbatim was transcribed and a thematic analysis was carried out. Results: Twenty-four caregivers were interviewed. Some 58.4 % were 70 years old and older and 58.3 % were spouses of the patients. Four categories of themes emerged, leading to the identification of the following dietary challenges: changes in food habits (e.g. modification of food preferences); eating behavior disturbances (e.g.forgetting meals); dependence for meal preparation. The usefulness of the nutrition counseling, the kindness and the competence of the NIS personnel, the written material offered and the length of the follow-up were appreciated by the caregivers. Conclusion: A better understanding of the caregiver’s experience is essential for the development of nutrition interventions adapted to the needs of caregivers and older adults with AD.

Master of Science / Department of Family Studies Human Services / Rick J. Scheidt / Currently in the United States there are 2.7 million grandparent caregivers caring for 5.4 million grandchildren, with 883,386 of these grandparents caring for their grandchildren without any assistance from the child’s biological parent. These grandparents have unique needs and require support services that understand and recognize those needs. However, many of the resources currently available are not designed to assist this population. This report explores many of the issues grandparents face when taking over as the primary caregiver for their grandchild. Specifically this report highlights the financial, legal, and medical issues, as well as the need for respite care and housing. These particular issues were selected because they are commonly cited as difficult areas to navigate for grandparent caregivers, and also because there are crucial resources in each of these areas that allow grandparents to successfully raise their grandchild. Without these tools, the process of raising the grandchild can prove extremely difficult for grandparents, which can have negative consequences on the grandchildren. In addition it offers suggestions for grandparents seeking assistance regarding these issues, also providing several resources. This report also offers guidance for grandparent caregiver advocates and encourages future research and scholarship to explore programs assisting this population.

The aim of this study was to investigate factors that influence the burden of caregiving on the caregivers of children with cerebral palsy (CP) in Windhoek, Namibia. Ethical approval was obtained from researcher’s university and Namibia Ministry of Health and Social Services ethics committee. A quantitative, non-experimental, descriptive and cross-sectional design in the form of a survey was used. Total population sampling technique was used to draw 91 respondents drawn from the patient register at the two public hospitals in Windhoek. A questionnaire adapted from the Zarit Burden Interview (ZBI) was used to collect data. Data which was obtained was complete and the researcher paid consistent attention to the data collection process. The results showed the following characteristics to be significantly related to increased burden among caregivers; living in the same household as a child with cerebral palsy, marital status, knowledge and understanding of cerebral palsy, ethnic group and caregiver having previously been treated for a physical ailment. It was recommended that the social grant and housing policies be reviewed, and support groups for caregivers and community awareness on cerebral palsy be introduced. / Health Studies / M. P. H. (Public Health)

Background: In 2015, Swaziland had a tuberculosis (TB) prevalence of 733 per 100 000 population and HIV prevalence of 27.5%. Baylor College of Medicine Children’s Foundation Swaziland (BCMCFSD) reported 83% prevalence of malnutrition amongst children in 2014. No study has described the association between malnutrition and childhood TB in Swaziland. Purpose: To examine the association between malnutrition and diagnosed drug susceptible tuberculosis (TB) amongst children aged zero to fifteen years old in Swaziland. Method: The Mixed Method approach was used to conduct the study. A total of 306 children’s electronic records were extracted, then 12 children’s caregivers interviewed. Extracted data were cleaned and exported to an excel database, then analysed using STATA version 14 by a statistician. Qualitative data were analysed using NVIVO version 11 post the analysis of the quantitative data. Triangulation of quantitative and qualitative results was conducted to obtain a comprehensive picture of the study. Validity, reliability, trustworthiness and adherence to ethical considerations were maintained. Results: History of previous TB treatment, HIV status and age were strongly associated with poor TB outcome (<0.001) and severe malnutrition (<0.002). Sex, regions and TB type were statistically insignificant. Nutritional situation at home and nutritional support from the health care facility, emerged as themes. Conclusion: TB and Malnutrition are significant predictors of children mortality, thus the children caregivers need consistent health education and support. / Health Studies / M. P. H