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Background:
The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia.
Methods:
A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Ser...
Context in source publication
Context 1
... informal caregiver's fatigue severity scale (FSS) showed an average score of 3.5 ± 1.8, with a minimal observed value of one, and maximal value of seven. The sociodemographic characteristics, SF-12, and the FSS of informal caregivers are presented in Table 1. Care recipients were mostly women (60.2%) older than 65 years (80.4%). ...Citations
... 8 Lastly, individuals may have concerns about transmission of COVID-19 infection to vulnerable family members, including the elderly, children, and patients with disease, who may have a higher risk of severe symptoms, morbidity, and mortality with COVID-19 infection. 37 This problem may be more pronounced in South Korea, where the proportion of the elderly population has been steadily increasing since 2001. 38 In an effort to prevent the infection of vulnerable populations within families, restrictions on social interactions and daily activities are imposed on both the vulnerable individuals and their families, which potentially makes vulnerable people more dependent on their families. ...
Objective
This study examined the mediating effect of negative changes in daily life due to the coronavirus disease-2019 (COVID-19) pandemic on depressive symptoms, considering COVID-19 infection and related social concerns. Additionally, comparisons of path coefficients between the groups were conducted based on age and gender.
Methods
A cross-sectional study design used data from the 2020 Korean Community Health Survey consisting of 229,269 individuals. This study used a self-reported questionnaire, including the Patient Health Questionnaire-9 and three items addressing social concerns related to COVID-19 infection. A single question assessed whether individuals had experienced COVID-19 infection within the last 3 months, and scores of negative changes in daily life due to the COVID-19 pandemic. Correlation analysis was performed on the variables. Structural equation model analysis was conducted to identify the mediating role of negative changes in daily life. Chi-square tests were also performed to compare the path coefficients based on age and gender.
Results
The structural equation models revealed that COVID-19 infection and related social concerns had both significant direct effects on depressive symptoms and indirect effects through negative changes in daily life. When comparing the path coefficients by age and gender, the coefficients related to depressive symptoms were highest in those under 65 years and in females.
Conclusion
Negative changes in daily life due to the COVID-19 pandemic serve as a partial mediator of the impact of COVID-19 infection and related social concerns on depressive symptoms. Special attention should be paid to depressive symptoms in those under 65 years of age and in females.
... In addition to the overlapping functions being directly related to the development of suffering and mental disorders in mothers, the pandemic is an aggravating factor for mental health, due to increased anxiety, stress, frustration and boredom, loneliness, irritability, sadness and various fears (of contamination, lack of supplies and decreased income) (5,8,11,(24)(25) , which justifies the results about the "terrible" feeling reported by mothers and lack of care for maternal mental health. ...
Objetivo: avaliar a qualidade de vida materna durante a pandemia da Covid-19. Método: estudo transversal exploratório, quantitativo, com amostra definida com o método de Bola de Neve virtual. A coleta ocorreu de modo on-line entre junho e setembro de 2021. Utilizou-se um formulário semiestruturado sobre questões socioeconômicas e o instrumento abreviado de avaliação de qualidade de vida da Organização Mundial da Saúde. A análise de dados incluiu estatística descritiva, testes de Qui-Quadrado de Pearson, Exato de Fisher e Regressão Logística Múltipla. Para todas as análises, considerou-se p-valor <0,05. Resultados: 305 respostas de mulheres com média de 1,6 crianças. A inequidade de gênero esteve presente. Houve significância estatística entre raça/cor parda (58,3%; p=0,045), renda de até um salário-mínimo (67,9%; p<0,001) e baixa qualidade de vida. Maior probabilidade de baixa qualidade de vida em mães que não dividiam responsabilidades sobre os cuidados dos filhos (OR 3,18) e para as que não cuidavam da saúde mental (OR 2,45). Conclusão: o bem-estar emocional e a qualidade de vida das mães de crianças, em distanciamento social, durante a pandemia, foram baixos. A rede de apoio é fator protetor da saúde mental e qualidade de vida dessa população. Discussões sobre gênero e atribuições com os filhos se fazem necessárias.
... It was revealed that received support was strongly correlated with depression [11]. During the COVID-19 pandemic, providing psychosocial support was crucial for mitigating depressive risks among informal caregivers [12]. However, perceptions of the pandemic varied significantly and were influenced by individual psychological and social resilience, which involved diverse coping strategies [13]. ...
Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.
... Consistent with fndings from other studies, which have demonstrated that heavier caregiver burden is associated with poorer physical health, some individuals report neglecting their physical health or completely forgoing exercise due to the constant need for support and care. Tese results provide evidence that functional capacity in activities of daily living is an important indicator of caregiver role strain [63,64]. ...
Introduction. Increased life expectancy leads to consequent long-term care needs, where informal caregivers may experience overload and strain associated with caregiving, influencing the well-being and health of individuals and eventually leading to an effort to fulfill their role. Within this context, a condition called caregiver role strain has been identified. Objective. To investigate the clinical indicators of the nursing diagnosis caregiver role strain as described in the literature. Materials and Methods. This study is a systematic review of diagnostic accuracy conducted in October 2023, following the recommendations of the Joanna Briggs Institute. The review protocol was registered and approved in the Prospective International Register of Systematic Reviews under registration number CRD42022377411. The QUADAS-2 tool was used to assess the risk of bias and quality of the studies. The databases included SciVerse Scopus (Elsevier), MEDLINE/PubMed (via National Library of Medicine), Latin American and Caribbean Health Sciences Literature (LILACS), CINAHL with Full Text (EBSCO), and PsycINFO (APA), with 48 articles included for quantitative synthesis. Results. Fourteen defining characteristics were identified from the literature, with a predominance of the following indicators: depressive symptoms (45.8%), anxiety (41.6%), physical decline (31.2%), fatigue (22.9%), disturbed sleep pattern (20.8%), emotional disturbance, and irritability (16.6%). The findings suggest that, within the defined circumstances and limitations of the study, examining defining characteristics for the diagnosis caregiver role strain holds potential for advancing scientific knowledge regarding human responses to the challenges experienced by caregivers. Evidence for Practice. The study aligns with clinically relevant indicators crucial for refining and updating the diagnosis, thereby enhancing its level of evidence and clinical accuracy. Simultaneously, it supports addressing the gap in caregiver support and standardized nursing care plans.
... Individuals with no moderate or severe symptoms of anxiety provided help to others because of the pandemic. Research has shown that the majority of informal caregivers during the pandemic had experienced burden with more than one in four also experiencing symptoms of depression (Rajovic et al., 2021). Future research should also focus on the long-term mental health of individuals who gave support to their community and assess changes in patterns of anxiety or depression. ...
Objectives
Few are the longitudinal studies on the changes in moderate or severe symptoms of anxiety or depression (MSS-ANXDEP) from before to during the COVID-19 pandemic in Canada. The aim was to study the change in MSS-ANXDEP and associated sociodemographic, economic, psychosocial, health behaviour and lifestyle, and clinical factors.
Methods
The current sample includes 59,997 adults aged ≥ 35 years participating in the 2018 and 2020 health surveys of the 5 established cohorts of the Canadian Partnership for Tomorrow’s Health (CanPath). MSS-ANXDEP was based on a cutoff score ≥ 10 on the 7-item Generalized Anxiety Disorder Scale and Patient Health Questionnaire (PHQ-8). Change in MSS-ANXDEP was categorized as follows: no MSS-ANXDEP, remitted, incident, and persistent. Multinomial regressions were used to study MSS-ANXDEP as a function of sociodemographic, economic, psychosocial, health behaviours and lifestyle, and clinical factors.
Results
Sociodemographic and economic (i.e. age, gender, cohort, race/ethnicity, lower income, decreased in income, work status, being an essential worker), lifestyle and health behaviours (i.e. smoking, cannabis and alcohol use, drinking more alcohol), psychosocial (i.e. provide help to others, information and instrumental support, and change in relationships with friends, family, and partner) and clinical factors (i.e. lifetime mental disorder and multimorbidity) were associated with remitted, incident, and persistent MSS-ANXDEP.
Conclusion
Health and socio-economic factors were associated with changes in symptoms of anxiety and depression during the pandemic, further increasing inequities in mental health needs. Public health campaigns on the importance of healthy behaviours should continue and health policies should reduce economic and social barriers to integrated substance use and mental health care.
... Perceived stressfulness due to COVID-19 may be another significant determinant affecting long-term caregiving burden (Cluver et al. 2020). As the pandemic endures, several COVID-19 stressors experienced by caregivers have amplified caregiving burden (Archer et al. 2021) and depressive symptoms (Rajovic et al. 2021;Wister et al. 2022). Moreover, information about the disease and the steps taken within a given community to respond to surges in infection rates were erratic, without a cohesive national response in the United States, for the first year of the pandemic. ...
... We found that COVID-19-specific stress was positively associated with caregiving burden. This result is consistent with research reporting high levels of caregiving burden during the pandemic (Budnick et al. 2021;Rajovic et al. 2021;Russell et al. 2020). More specifically, during the pandemic, both the total amount of stress exposure and perceived stressfulness were positively associated with caregiving burden. ...
Objectives
Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers’ mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers’ mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated.
Methods
This study analyzed data collected in April 2021 from 154 family caregivers ( M age = 38.79, SD age = 9.36, range = 22–64) recruited through Amazon’s Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated.
Results
Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors.
Significance of results
The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic.
... Furthermore, patients with various cancers experience co-morbid psychological distress. For example, a study conducted in Iran showed that depression, anxiety, and stress prevalence in cancer patients was 28.4%, 43.2%, and 14.7%, respectively [7]. Cancer affects not only the patient, but also the family members who care for them who experience adverse outcomes [8]. ...
... During the COVID-19 pandemic, contacts between patients and caregivers at home, and associated provision of day-to-day care increased. The results of a study in the COVID-19 pandemic confirm such findings [43]. ...
Purpose
The study aimed to evaluate the changes in the care burden and quality of life of caregivers of cancer patients and correlates of care burden during the COVID-19 pandemic.
Methods
This cross-sectional study used the census sampling technique with 260 cancer patients and their caregivers in Shahroud, Iran during January to March 2020 in northeast Iran. Data collection tools included the Novak and Guest Care Burden Scale, the SF-36 Quality of Life Questionnaire, and the Stress, Anxiety, and Depression Scale (DASS-21). Data were analyzed using descriptive and inferential statistics (independent t-test and multiple linear regression analysis).
Results
Baseline scores of care burden and quality of life in caregivers suggested mild to moderate care burden and a reasonable quality of life and moderate levels of stress, anxiety, and depression in patients. The post-outbreak mean scores of care burden and quality of life significantly decreased and increased, respectively (p < .001). Regression analysis showed that 39.3% of the changes in the care burden score during the pandemic could be predicted by studied variables. In exchange for increasing the quality-of-life score and daily care hours, the care burden score decreases and increases. The burden of care in caregivers was also related to the type of cancer. Care burden in the caregivers of patients with breast and neurological malignancies was lower than the caregivers of patients with gastrointestinal cancer (p < .05).
Conclusion
Despite the results obtained, supportive and educational interventions are needed to reduce the caregiver burden and improve the quality of life of caregivers and measure its impact on levels of psychological distress in their patients clinically.
... Univariate and multivariate logistic regression models were used to assess predictors of depression (as dependent variable). Path analysis was conducted as it allows the estimation of the direct and indirect effects of the multiple determinants through the simultaneous modeling of related regression relationships [39]. Multiple measures were used to assess the proposed model, which includes the χ 2 test and the following fit indices: The Goodness of Fit Index (GFI), the Tucker-Normed Fit Index (NFI), the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RMSEA). ...
Background:
Sarcopenia is an age-related progressive, generalized skeletal muscle disorder involving the accelerated loss of muscle function and muscle mass. The aim of this study was to assess the complex relationship between sarcopenia, malnutrition, cognitive impairment, physical activity, and depression in the elderly, with the potential role of quality of life as a mediator in these associations.
Methods:
A cross-sectional study was conducted on a sample (n = 298) of elderly patients admitted to Special Hospital for Rehabilitation "Termal", Vrdnik, Serbia. Sarcopenia, the risk for malnutrition, cognitive impairment, physical activity, quality of life, and depressive symptoms were measured by standardized instruments. Additional data included sociodemographic characteristics. Simultaneous assessment of the direct and indirect relationships of all determinants was performed by path analysis.
Results:
A total of 40% (n = 120) of the elderly were diagnosed with sarcopenia, and 42.6% had depression symptoms. The risk of malnutrition was present in 23.5%, cognitive impairment in 5.4%, and a low level of physical activity was reported in 26.2% of elderly participants. The mean reported quality of life measured by Sarcopenia and Quality of Life Questionnaire was 60 (on the scale ranging from 0 to 100; where a higher score reflects a higher quality of life). The best-fitted model (χ2/DF = 1.885, NFI = 0.987, CFI = 0.993, GFI = 0.997, RMSEA = 0.055) highlighted the mediating effect of quality of life between sarcopenia, malnutrition, cognitive impairment, lower level of physical activities and depression. According to the model, quality of life was a direct negative predictor of depressive symptoms in the elderly, while malnutrition positively affected depression.
Conclusions:
The presented path model may assist rehabilitation centers in developing strategies to screen for sarcopenia and risk of malnutrition, and promote physical activity in elderly, aiming to prevent their negative effects on mental health. For the elderly currently affected by sarcopenia, we consider regenerative medicine and stem cell therapy, which, in view of their etiology, could be a potential therapeutic strategy for sarcopenia.
... Fatigue Severity Scale. The FSS consists of nine items that assess the intensity and severity of fatigue in relation to certain activities in the evaluated patients (Rajovic et al., 2021;Valderramas et al., 2012). The items are scored on a Likert scale, where 1 corresponds to "strongly disagree" and 7 corresponds to "strongly agree." ...
Objectives:
This study aimed to analyze cognitive impairment associated with long-term coronavirus disease 2019 (COVID-19) syndrome and its correlation with anxiety, depression, and fatigue in patients infected with severe acute respiratory syndrome coronavirus.
Methods:
This was a cross-sectional study of 127 patients with COVID-19. Tests to screen for neuropsychiatric symptoms included the Fatigue Severity Scale, Mini-Mental State Exam 2 (MMSE-2), Symbol Digit Modalities Test (SDMT), and Hospital Anxiety and Depression Scale.
Results:
In cognitive tests, SDMT was abnormal in 22%, being more sensitive than MMSE-2 to detect cognitive changes. Furthermore, although manifestations such as fatigue, depression, and anxiety were frequent in the post-COVID-19 phase, these 3 conditions, known to contribute to cognitive impairment, were slightly correlated with worse performance on the rapid screening tests.
Conclusions:
In patients with mild COVID-19 and cognitive complaints, SDMT helped to confirm disturbances in the attention domain and processing speed.
... However, the researchers also suggested that ICs whose burden increased during the pandemic may have already exhibited risk factors for high caregiver burden prior to its onset. Studies from the Netherlands and Serbia [98,99] found that the declining health of ICs and care recipients during COVID-19 was related to an increased level of perceived burden of care. While several studies have examined specific individual characteristics of caregiving situations during the pandemic [12,18,20,25,43,44,[67][68][69][82][83][84][85][86][87][88][89][90][91][92], only one study comprehensively examined the caregiving situation and care involvement [66], and the same study was the only one that examined the caregiving situation in relation to psychosocial burdens. ...
... In our study, the ICs of older people who provided more demanding and intensive care experienced a higher subjective burden of care. These findings are consistent with the results of several other studies [18,43,66,70,91,99,124,125] that found a high and increased caregiver burden during the COVID-19 pandemic. A German study of 1000 ICs [66] found that 25.5% to 39.7% of ICs reported that their caregiving situations somewhat or greatly worsened during the COVID-19 pandemic, especially among those caring for a person with dementia or who normally relied on professional help. ...
... Furthermore, a German study by Bergmann and Wagner [18] found that ICs who cared for their parents during the first phase of the pandemic in spring/summer 2020, and who increased the frequency of personal care, reported significantly more psychological distress (e.g., sadness, depression, anxiety, and nervousness). According to Rajovic et al. [99], caregiver burden is a mediating factor between determinants of the caregiving process (ADL, duration of care, level of care complexity, social support, financial support, and physical health) and indirect effects on depressive symptomatology. A cross-sectional study on ICs in 41 Serbian municipalities during the first phase of the pandemic found that more than two-thirds (71.9%) of ICs in Serbia experienced a mild to severe burden, and more than one-quarter (27.1%) had mild to severe depression symptomatology. ...
The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to investigate how a caregiving situation’s characteristics predict the subjective burden of care in times of COVID-19. The study was conducted in April and May 2021 via an online access panel. The sample (n = 612) was determined using a screening test that enabled us to focus on a Slovenian population of informal caregivers aged 40+ caring for a person aged 65+ for at least four hours/week on average. Our findings reveal that the subjective burden of care was high among informal caregivers during COVID-19. Multiple regression analysis showed that the provision of activities of daily living, care duration, average hours of care per week, formal care status, and recipients’ health problems related to dementia or other memory problems significantly predicted the subjective burden of caregivers. These findings call for better recognition of the role of informal caregivers. The time and effort devoted to informal care should be supported by legislation and social security.