Health Care for the Older Person

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https://hdl.handle.net/2328/35037

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Browsing Health Care for the Older Person by Author "He, Guo-Ping"

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    Factors contributing to caregiver burden in dementia in a country without formal caregiver support
    (Taylor & Francis, 2014-03-31) Wang (RN), Jing; Xiao, Lily Dongxia; He, Guo-Ping; Ullah, Shahid; De Bellis, Anita Marie
    Objectives: 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.
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    Family caregiver challenges in dementia care in a country with undeveloped dementia services
    (Wiley, 2014-06) Wang (RN), Jing; Xiao, Lily Dongxia; He, Guo-Ping; De Bellis, Anita Marie
    Aims To examine socially, culturally and politically constructed factors affecting family caregiver practice in dementia care, and to identify possible changes in a country with undeveloped dementia services. Background In China and many other low- and middle-income countries, social transformations are weakening the family care model, which has an impact on the population with dementia. Exploring the challenges that caregivers face may help the international healthcare community to improve dementia services. Design A double hermeneutic approach informed by Giddens' Structuration Theory was used. Methods In-depth semi-structured interviews with 23 family caregivers of people with dementia were conducted in 2012. The interviews were audiotaped, transcribed and analysed. Findings Analyses revealed three consequences of socially constructed factors in dementia care, which constrained caregiver practice. First, caregivers were unable to manage behavioural and psychological symptoms of dementia. Untreated aggressive behaviours caused harm to the person with dementia and endangered the caregiver and the public. Second, the burden on the primary caregiver was evident and caregivers received limited support. Third, there was little coordination between primary and specialist care services for people with dementia. On critical reflection of potential changes that could improve dementia services, caregivers suggested that community nurses have a leading role in coordinating dementia services and supporting caregivers. Conclusion Relying on family caregivers to care for people with dementia without the prevision of dementia services by the public healthcare system generates negative health outcomes for both care recipients and caregivers. The nursing workforce should be developed to support dementia services.
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    Family caregiver challenges in dementia care in Australia and China: a critical perspective
    (BioMed Central, 2014) Xiao, Lily Dongxia; Wang (RN), Jing; He, Guo-Ping; De Bellis, Anita Marie; Verbeeck, Jenny; Kyriaxopoulos, Helena
    Background: Both Australia and China have a large proportion of people with dementia and the prevalence will triple in Australia and increase five times in China by 2050. The majority of people with dementia are reliant on family caregivers to provide daily care and to maintain the dignity in both countries. As a consequence, caregiver burden has become a major concern because of the negative impact on the care recipients’ and the caregivers’ health. It is strongly recommended that cross-national collaboration should be conducted to share experiences in fighting dementia. The aim of this study was to compare socially and culturally constructed enablers and barriers pertinent to dementia caregivers in one capital city in Australia and one capital city in China through critical reflection on the caregivers’ subjective and objective experiences for the improvement of dementia care services in both countries. Methods: Giddens’ Structuration Theory was used as a framework to guide a concurrent mixed methods design with the qualitative strand as a priority. In the qualitative strand, data were collected by focus groups and in-depth interviews while in the quantitative strand, data were collected by questionnaire survey. Results: In total 148 caregivers participated in the project with 57 of them from Australia (26 and 31 in the qualitative and quantitative strands respectively) and 91 of them from China (23 and 68 in the qualitative and quantitative strands respectively). Findings from the qualitative and quantitative strands were presented as three categories: A higher objective burden in the Chinese cohort versus a higher subjective burden in the Australian cohort; Unmet need for caregiver support in Australia and China; and Expectations for improving dementia services in Australia and for developing dementia services in China. Conclusions: Dementia policy, services and resources need to be grounded on current research evidence in an ever-changing society like China. In Australia, dementia services need to have more components of preventing or reducing caregivers’ subjective burden. As subjective burden is mediated
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    以人为中心照护服务测评量表的研究进展
    (China Academic Journal Electronic Publishing House, 2013) Wang, Yan-Jiang; Xiao, Lily Dongxia; Wang (RN), Jing; De Bellis, Anita Marie; He, Guo-Ping
    【摘要】目前以人为中心的照护服务被广泛应用于医疗护理领域，国内外常用的以人为中心照护服务的测评量 表主要有两大类: 针对老年痴呆症患者的评定量表和用于老年护理的普适性量表。本文就以人为中心照护服务的测评 工具在老年护理和痴呆症照护中的应用及研究进展进行综述。应加强以人为中心照护服务测评量表的研究，发展并制 定出适合我国国情的量表，才能更好地评价照护服务的质量，同时为制定干预策略提供依据。 Abstract: Person - centered care is used widely in the field of medical care at present． There are mainly two categories of person - centered care assessment tools． One category is for the Alzheimer's disease，and the other is for the elderly care． In this paper we review the application of the person - centered care assessment tools in the elderly care and care for the patients with Alzheimer's disease，and the progress in research of the tools． It is necessary to enhance the research on person - centered care assessment tools so as to develop the tools that are suitable for our national conditions in order to assess the quality of care better and provide basis for the intervention.
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    老年痴呆患者家庭照护者负担及其应对策略
    (Zhongguo Laonian Xuehui, 2014) Wang (RN), Jing; Xiao, Lily Dongxia; He, Guo-Ping
    【摘要】：正老年痴呆主要包括阿尔茨海默病和血管性痴呆,患者表现为认知功能损害和精神行为症状,最终生活无法自理,不仅严重影响患者的生活质量,也给家庭和社会带来沉重的负担〔1〕。由于照护的性质,如照护者需要24 h不间断地看护痴呆症老人以及在应对痴呆症老人精神和行为症状过程中的困难,照护居家痴呆症老人被公认为是一项极具挑战性的工作〔2,3〕。各种并发症如尿失禁、压力性溃疡、跌倒及营养不良所致的髋关节骨折等进一步加重了痴呆老人的照护需求。据文献报道,高达.