How Concurrent Services Obscured Detection of Intervention Benefits: Part 2: Secondary Analysis of the PREP Trial for Frail Older Adults and Family Caregivers.

Family caregivers frequently use health and social services to support their caregiving. In evaluating care-giving interventions, however, researchers rarely examine the influences of such concurrent services on intervention effectiveness. In this Part 2 secondary analysis of data from the Oregon Health & Science University/Kaiser Permanente Northwest Region Family Care Study, we examined the moderating influences of concurrent services on intervention effectiveness.

How Tailoring Led to Variation in Care Issues, Dosage, and Outcomes: Part 1: Secondary Analysis of the PREP Trial for Frail Older Adults and Family Caregivers.

In family caregiving interventions for adults with health problems, tailoring has become the norm. Studies that evaluate tailored interventions, however, have rarely included intentional variation in dosage or explored the dosage-outcome association. In this Part 1 secondary analysis, we examine dosage and outcomes in intervention families ( = 116) who participated in the Oregon Health & Science University/Kaiser Permanente Northwest Region Family Care Study.

Building Academic Geriatric Nursing Capacity: results after the first 10 years and implications for the future.

In 2000, the John A. Hartford Foundation launched a multi-million dollar investment in Building Academic Geriatric Nursing Capacity (BAGNC) at the American Academy of Nursing (AAN). After a decade of focused support to increase scholarship, research, leadership, and institutional collaboration, is there evidence this program is successful in achieving its goals? Equally important, as the need for quality geriatric nursing care increases with the expanding aging population and associated complex health conditions, how does the experience and outcomes of this program inform nursing's future? To address both questions, the authors first provide an overview of geriatric nursing prior to and up to the time the BAGNC program began, then review results of an external evaluation of the BAGNC program, and finally propose goals and strategies for the next 20 years of academic geriatric nursing.

Does age make a difference in caregiver strain? Comparison of young versus older caregivers in early-stage Parkinson's disease.

Family care research has identified negative outcomes of providing care to a spouse with Parkinson's disease (PD), such as declining physical and mental health. Research has also identified protective variables that decrease negative outcomes such as high mutuality and rewards of meaning. It is important for clinicians to identify "at risk" family caregivers and provide earlier interventions.

Optimism, pessimism, mutuality, and gender: predicting 10-year role strain in Parkinson's disease spouses.

Purpose: There is wide variability in how spouses providing care respond to their care situations. Few studies focus on the roles of both intra- and interpersonal factors in long-term spousal care, particularly in the context of Parkinson's disease (PD). The current study uses longitudinal data over a 10-year period to examine the roles of optimism, pessimism, mutuality, and spouse gender in predicting role strain in PD spouses.

The Spanish Version of the Mutuality Scale: evidence for the cultural equivalence of mutuality in Mexican American families.

Mutuality, the positive quality of the relationship between the family caregiver and care receiver, is an important variable in family care for frail older adults. It has been shown to be associated with lower levels of caregiver strain and higher levels of caregiving rewards. However, the concept and measure of mutuality were developed with non-Hispanic White samples.

Do motor and nonmotor symptoms in PD patients predict caregiver strain and depression?

Our objective was to understand the impact of motor and nonmotor symptoms of patients with early and middle stage Parkinson's disease (PD) on their spouses' caregiver strain and depression. A sample of 219 spouse caregivers of PD patients participating in a clinical trial was evaluated for six dimensions of caregiver strain and depression using the Family Care Inventory. Motor and nonmotor (i.

Effects of caregiving demand, mutuality, and preparedness on family caregiver outcomes during cancer treatment.

Purpose/objectives: To test a model of family caregiving derived from the interactionist approach to role theory that hypothesized that three caregiving role implementation variables (caregiving demand, mutuality between caregivers and patients, and preparedness for caregiving) would predict multiple caregiving-specific and generic outcomes with different patterns of association across outcomes.

Design: Descriptive, correlational.

Setting: Surgical, radiation, and medical oncology settings.

Mutuality and preparedness moderate the effects of caregiving demand on cancer family caregiver outcomes.

Background: Family caregiving researchers have explored the moderating or stress-buffering effects of variables such as coping and social support. However, the quality of the family caregiver-patient relationship and preparedness for caregiving have received little attention as potential moderators.

Objective: To explore whether relationship quality and preparedness moderate the effects of caregiving demand on caregiver outcomes during cancer treatment.

The enduring and contextual effects of physical health and depression on care-dyad mutuality.

Mutuality is a protective factor in family care situations, but little is known about changes in care-dyad mutuality. In this study, we examined mutuality in 103 care dyads over 20 months, and the enduring and contextual impact of older adult and family caregiver health on changes in mutuality. Care dyads consisted of frail older adults and their family caregiver.

Explaining family caregiver role strain following autologous blood and marrow transplantation.

This research project explores family caregiving processes during the first 100 days following autologous blood and marrow transplantation (ABMT). In this paper, we (1) explore patterns in caregiving, and ABMT recipient function early recovery from ABMT; (2) examine the relationships among caregiver demographics, relationship quality, preparedness, ABMT recipient function, predictability of caregiving, caregiver role strain and rewards of caregiving; and (3) examine the relative contribution of caregiver age, preparedness, relationship quality, and ABMT recipient function on caregiver role strain, and rewards of caregiving. Fifty-two family caregivers of ABMT recipients completed questionnaires about caregiving at hospital discharge, and again 2, 6, and 12 weeks following discharge.

How frail elders evaluate their caregiver's role enactment: a scale to measure affection, skill, and attentiveness.

In this validity study, using factor analysis, the authors identified three dimensions (affection, skill, and attentiveness) of the Care Receiver View of Caregiver Role Enactment Scale, a self-report measure designed to elicit an elderly care receiver's evaluation of how well their family member carried out the role of caregiver. The scale is a revision of the Satisfaction With Caregiving Scale. This study was a secondary analysis of data from PREP: Family-based Care for Frail Older Persons.

Family caregivers making life-sustaining treatment decisions: factors associated with role strain and ease.

Although recent studies have focused on life-sustaining treatment (LST) decision-making by families, research has not examined such decision-making as an aspect of ongoing caregiving by family caregivers. This article focuses on factors associated with family caregiver role strain and ease in LST decision-making. Using content analysis, factors were derived from interview data gathered from 17 family caregivers who had made LST decisions for 16 elderly ill relatives.

Pessimism and optimism as early warning signs for compromised health for caregivers of patients with Parkinson's disease.

Background: Although pessimism and optimism are associated with health-related outcomes, the long-term effects of pessimism and optimism in the caregiving process are understudied, and little is known about their role in health changes over time.

Objective: To determine whether pessimism and optimism can be used as early warning signs for negative changes in caregiver depressive symptoms and physical health over a 10-year period.

Methods: Multilevel modeling was used to examine longitudinal data from 311 spouse caregivers of individuals with Parkinson's disease, with data points at baseline, Year 2, and Year 10.

Role strain and ease in decision-making to withdraw or withhold life support for elderly relatives.

Purpose: To describe the concepts of role strain and role satisfaction (renamed ease in decision-making following analysis) experienced by family caregivers when making decisions to withdraw or withhold life support for elderly relatives in a variety of settings.

Methods: Semi-structured interviews were conducted with 17 family caregivers to obtain descriptions of their experiences when making decisions about life support for elderly relatives. Content analysis was used to analyze the data.

Locating and retaining research participants for follow-up studies.

Two common pitfalls of longitudinal research are loss of participants over time and inability to locate participants whose contact information has changed. This article is based on our experiences in locating and retaining a sample of caregivers of persons with Parkinson's disease 8-10 years after we last contacted them. The strategies we used resulted in locating 86% of our sample and retaining 80% of those who were eligible.

Home environmental modification strategies used by caregivers of elders.

Although several definitions and categorizations of home environmental modification strategies exist, previous researchers have not addressed whether the conceptualizations developed by clinicians and researchers match the way families think about how they modify the home environment in order to provide care to frail elders. The aim of the analysis reported here was to describe, from the family's perspective, the home environmental modification strategies that they use. Twenty-four caregivers of community-dwelling elders with a variety of impairments were interviewed.