PubMed · 15861915
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Paule Birot, Marie Pierre Dervaux, Martine Pegon. 2005. [McGill model].. https://pubmed.ncbi.nlm.nih.gov/15861915/
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BACKGROUND: Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD). PROCEDURE: Fourteen maternal caregivers of children with SCD were interviewed as part of a larger study of maternal caregivers of children with chronic illness. Forty-four caregivers of children with HIV and 36 caregivers of healthy children were included as comparison groups. Interviews included questions regarding amount of time spent providing care for the child (technical care, non-technical care, health care management), hospitalization, emergency room visits, illness stigma, and mental health of the caregiver. RESULTS: Children with SCD had significantly lower functional status and significantly more hospitalizations in the previous 3 months than children with HIV. Caregivers of children with SCD were more likely to work full-time and had higher incomes than caregivers of children with HIV. The three caregiving groups did not differ significantly on amount of total care, although caregivers of children with SCD and caregivers of children with HIV both reported significantly more time spent in technical care than caregivers of healthy children. Despite lower functional status of the children in the SCD group, when group comparisons on caregiving time variables were adjusted for child's functional status, the differences between groups increased. This appeared to be due to the fact that caregivers in the HIV group spent more time in all caregiving categories except skin, crisis, and other care. In terms of caregiver mental health, caregivers of children with HIV and SCD had significantly higher depressive mood scores than caregivers of healthy children but the groups did not differ on caregiving burden. CONCLUSIONS: The perceived care burden of caregivers of children with SCD may be related to the unpredictable nature of the crisis care they provide. Additional attention is warranted to developing adequate resources for caregivers of children with SCD to mitigate the stress of unexpected crises.
GOALS OF WORK: This study reflects variables being depicted as predictors of global quality of life in current research. The evaluation was conducted at the Division of Clinical Oncology at the Medical University in Graz, Austria. PATIENTS AND METHODS: A sample of 210 breast cancer patients between ages 30 and 80 years was assessed 1-5 years after initial diagnosis in a tumor-free stage. Besides the socio-demographic and medical variables, the Brief Symptom Inventory (BSI), Impact of Event Scale (IES), Mental Adjustment to Cancer (MAC), and the Perceived Family Support (PFS) were used. To identify variables related to quality of life, stepwise multiple regression analyses were calculated. MAIN RESULTS: In a regression analysis, the general severity index (BSI) was identified as the most important and helplessness/hopelessness (MAC) as the second important variable related to QoL. Including the BSI-subscales as predictors, the depression-subscale (BSI) explained 25% of the variance; in addition, somatization (BSI), helplessness/hopelessness (MAC), and having financial problems (semi-structured interview) were significantly related to global quality of life, but the medical variables showed no associations to the measured quality of life. Depression itself is associated with negative the impact of cancer, the number of stressful life events, being uncomfortable with the body, having financial problems and anxious preoccupation (MAC). CONCLUSIONS: The awareness of the role of multi-factorial and associated variables could provide patients, family, and medical staff with appropriate and adequate tools to treat specific symptoms.
Through December 2003, more than 55,300 persons were living in small towns and rural areas of the United States at the time of their AIDS diagnosis. Many HIV-infected rural persons experience elevated levels of depression, suicidal ideation, and anxiety. This research tested if two telephone-delivered, mental health interventions could facilitate the adjustment efforts of persons living with HIV/AIDS in rural areas of the United States. Participants (N=299) were recruited through AIDS service organizations in 13 states and assigned to a Usual Care Condition (n=107), an 8-session Information Support Group Intervention (n=84), or an 8-session Coping Improvement Group Intervention (n=108). Participants completed self-administered surveys at pre-intervention, post-intervention, and 4- and 8-month follow-ups. ANCOVA revealed that no treatment condition produced reductions in the main outcome measures of depressive and psychological symptoms; however, Information Support participants received significantly more support from friends at 4- and 8-month follow-ups and reported fewer barriers to health care and social services at 4-month follow-up compared to participants in the other two conditions. Telephone-delivered, information-support groups have potential to increase perceptions of support and reduce barriers to health care and social services in this population, but the practical significance of these intervention-related changes is limited.