Burden and Coping in Informal Caregivers--论文代写范文精选

一般有六个主要维度:接纳、幽默、宗教、药物使用、行为脱离和自我责备作为重要的应对技能。自我责备,行为脱缰发泄和情感支持,成为一个重要的变量，作为不同的照顾和护理负担。干预措施需要设计并根据护理人员的具体需求。下面的paper代写范文将进行详述。

Abstract
Caring for persons affected with dementia is associated with substantial psychological strain as evidenced by high rates of psychiatric morbidity and high levels of caregiver strain. Dementia care in developing countries will continue to be provided by immediate family members at home and is unlikely to be taken over by institutions due to socio-cultural reasons. This study aims to examine the relationship of selected factors of patients affected with dementia and their caregivers that were associated with the burden and coping of family caregivers. This is a cross sectional study of a long term project by the author (RJ), involves face-to-face interview with questionnaires with family caregivers of patients with dementia. 

Burden was related to patient’s behavioral problems, gender, family type and the years of care giving. Principal component analysis of Brief Cope revealed 6 major dimensions: acceptance, humor, religion, substance use, behavioral disengagement and self blame as significant coping skills. Care giving was associated with more psychological complaints and a poor quality of life both physical and psychological. Self blame, behavioral disengagement, venting & emotional support emerged as an important variable as the care giver relation differ in the kind of care giving and care giving burden. Results highlight the importance of improving the mixed coping skills in burdened caregivers. Interventions need to designed and tailored to the specific needs of caregivers.

Introduction
Dementia was estimated to be the 10th leading cause of nonfatal burden in the world in 1990, accounting for 2.6% of total YLD, around the same percentage as congenital malformations. (1) Even with the difficulties of determining prevalence and incidence, it is clear that dementia causes a substantial burden globally. India is currently in the second phase and is moving towards the third phase of demographic transition. The changes in the population growth rates in India have been relatively slow, but the change has been steady and sustained. 

As a result the country was able to achieve a relatively gradual change in the population numbers and age structure.(2) In context of the rapid demographic transition in many parts of the country, there is a rich epidemiological evidence base on dementia in India which shows this neurodegenerative condition is an important public health problem. Due to shortage of health care resources and low levels of awareness about dementia, interventions are addressing the needs of the people and directed at improving quality of life of the person dementia and the caregiver. In the Indian Society, the cultural values and the traditional practices emphasize that the elderly members of the family to be treated with honor and respect. 

The families of the aged persons are expected to ensure the needed care and support for the aged. However, recent changes in the size and structure of families have caused the re-arrangement of the roles and functions of the members in the families. In the absence of formal services in most developing countries there is a heavy reliance on informal and, in particular, family care for people with dementia.(3) The lack of research evidence from developing countries of the practical, emotional, and economic impact of caring for a family member with dementia allows the myth to be perpetuated.(4) The current study aims to examine the relationship of selected factors of patients affected with dementia and their caregivers that were associated with the burden and coping of family caregivers. Coping is most often conceptualized as a response to the demands of specific, stressful situations. In fact, providing care for a family member with dementia is associated with personal strain in number of stressful situations.(5)

Coping strategies
The literature on stress and coping has grown enormously over the past two decades. Studies have examined people’s responses to such disparate stressors as chronic illness, diagnosis with life-threatening illness, natural disasters, and the challenge of difficult examinations. Although several clear principles have been derived from this body of research as a whole, there is near-unanimity that many questions remain to be answered. Thus research into the coping process continues.(9)

Materials and Methods
This is a cross sectional study of a long term project by the author (RJ), involves face-to-face interview with family caregivers of patients with diagnosed cases of dementia. Participants willing were recruited through convenient sampling from psychiatry outpatient clinics from three hospitals, one university hospital, a district hospital and a private centre which runs a “memory clinic” once a week. Most of the clients were seen at their respective homes. The study comprised of 125 informal caregivers. 

About the questionnaires 
In this study reports on brief measure of coping reactions, based on the COPE inventory.(9) The Brief COPE includes only 28 items, which measure 14 conceptually differentiable coping reactions. Some of these reactions are known to be generally adaptive; others are known to be problematic. The Brief COPE thus provides researchers a way to assess potentially important coping responses quickly.

Conclusions
Results highlight the importance of improving the coping methods in burdened caregivers. Clinical significance to be given more importance than statistical significance. Interventions need to designed and tailored to the specific needs of caregivers. At present a memory clinic program is conducted in one of the selected caregiver setting once in a week and variety of interventions have been developed which aim to offer support for caregivers. Interventions include: training and education programmes and formal approaches to planning care which take into account the specific needs of carers and people with dementia using specially designated social workers and other members of the healthcare team.(论文代写)

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