Search Results (711)

Background/Objectives: Family caregivers of individuals with dementia frequently experience substantial psychological distress, yet their emotional responses are heterogeneous. Depression, anxiety and psychological well-being may co-occur in distinct patterns, and socio-economic resources such as education and income are often hypothesized to buffer caregiver distress. This study aimed to identify latent psychological profiles among dementia caregivers and to examine whether education and income moderate the association between affective symptoms and well-being. Methods: A cross-sectional study was conducted with 73 family caregivers of dementia patients attending the Neurology–Psychiatry Department of C.F.2 Clinical Hospital, Bucharest (November 2023–April 2024). Participants completed the PHQ-9 (depression), the COVI Anxiety Scale and Ryff’s Psychological Well-Being Scales. Care recipients’ cognitive status was extracted from medical records using the MMSE. Gaussian Mixture Modeling was used for latent profile analysis (LPA). Between-profile differences were examined using one-way ANOVAs and Tukey post-hoc tests and Pearson correlations were used to assess associations between affective symptoms and psychological well-being, and examined whether education and income were associated with profile membership and psychological well-being. Results: LPA supported a three-profile solution: (1) lower depressive symptoms with moderate anxiety (33%), (2) severe combined depression and anxiety (18%) and (3) moderately severe depression with severe anxiety (49%). Profiles differed significantly in depressive symptom severity, whereas anxiety severity did not differ significantly across profiles. Caregivers in Profile 3 (moderately severe depression–severe anxiety) reported significantly higher overall psychological well-being than those in Profile 1 (moderate depression–moderate anxiety). In contrast, caregivers in Profile 2 (severe depression–severe anxiety), who exhibited the highest affective symptom burden, showed intermediate levels of overall well-being, with comparatively lower scores on specific dimensions such as purpose in life. Depressive symptoms were weakly but significantly associated with autonomy and self-acceptance, whereas anxiety symptoms showed no significant associations with psychological well-being. Education level and household income were not significantly associated with profile membership or psychological well-being. Conclusions: Family caregivers of individuals with dementia can be meaningfully described as forming three exploratory psychological profiles characterized by different configurations of depressive and anxiety symptoms. These findings indicate that caregiver distress does not follow a simple severity gradient and that psychological well-being is not solely determined by symptom burden. Socio-economic characteristics did not account for differences in caregiver adjustment, underscoring the importance of individualized psychological assessment and tailored interventions to support caregiver mental health. Full article

From an interbehavioral and contingential perspective, family dialogues about sexuality are understood as patterns of verbal interaction regulated by social, gender, and caregiving contingencies rather than as individual attitudes or intentions. Background: This study analyzes the functional conditions under which family dialogues about sexuality occur between mothers and their adolescent sons and daughters, considering caregiving roles and gender norms that regulate these interactions. The research aimed to identify the functional relations between communicative practices and the social contingencies that maintain or inhibit them. Methods: A qualitative approach grounded in interbehavioral psychology was employed, using semistructured interviews with 40 mothers of students from a public middle school in Puebla, Mexico. Data were analyzed through contingency analysis, distinguishing micro- and macrocontingential systems related to family sexual education. Results: Results show that, although patterns of avoidance and discourse displacement toward schools or peers persist, families exhibit increasing openness toward comprehensive sexuality education and recognize its preventive value against violence, adolescent pregnancy, and misinformation. Functional delegation and adolescent mediation of dialogue were identified, along with emerging inclusive macrocontingencies linked to the acceptance of diverse families and LGBTIQ+ themes. Conclusions: It is concluded that households function as self-regulated interbehavioral systems in which historical and gender contingencies restrict sexual dialogue, yet gradual functional changes toward respect, inclusion, and shared educational responsibility are observed. Full article

Women with intellectual disabilities (IDs) face persistent health inequities, particularly in preventive services such as breast cancer screening, where participation rates remain disproportionately low. These disparities contribute to higher mortality and poorer survivorship outcomes, often linked to later-stage diagnoses. To better understand these challenges and inform the development of inclusive screening programs, this qualitative study conducted in Austria explored barriers, facilitators, and needs related to breast cancer screening from the dual perspectives of 17 women with mild-to-moderate IDs aged 45 and older and 10 caregivers. Semi-structured focus groups and interviews were analyzed thematically within a constructivist framework, integrating perspectives from both groups. Barriers included social taboos around sexuality, psychological distress, exclusion through standardized procedures, and unclear responsibility among stakeholders. Facilitators involved person-centered communication, accessible information, emotional and practical support, and familiar healthcare environments. Women with IDs expressed a strong desire for education, autonomy, and inclusion, while caregivers played a pivotal role in enabling access. These findings demonstrate that low screening participation among women with IDs is driven by systemic and organizational barriers rather than lack of health awareness or willingness to participate. Without structurally inclusive design, organized screening programs risk perpetuating preventable inequities in early detection. Embedding accessibility, clear accountability, and person-centered communication as standard features of breast cancer screening is therefore a public health priority to reduce avoidable late-stage diagnoses and narrow survival disparities for women with IDs. Full article

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. Full article

Background/Objectives: In 2023, the United States Congress amended Section 13 of the National School Lunch Act to allow non-congregate meal service as an option within the Summer Food Service Program in rural areas, creating “SUN Meals To-Go.” The purpose of this qualitative study was to explore caregivers’ perceptions of USDA rural non-congregate summer meal programs in California during the summer of 2024. Methods: This was a cross-sectional, qualitative study using an electronic 20-item survey instrument that was available in English and Spanish. Five school foodservice directors in California shared and/or posted at meal pick-up sites a flyer with a QR code leading caregivers to the survey instrument. A conventional content analysis was conducted with the open-ended responses and descriptive statistics were calculated for close-ended items. Results: Caregivers (n = 827) were primarily married (70.5%) and Hispanic/Latino (54.3%) women (85.5%). They (55%) reported using the 2024 summer meal program “most times” or “every time” it was available. Three themes were constructed through qualitative content analysis: (1) Family support and resource relief, (2) Navigating program accessibility and logistics, and (3) Nourishment and practicality: Reflections on food quality, nutrition, and sustainability. Conclusions: Caregivers highlighted that the program supported their families and provided resource relief. They indicated that accessibility and logistics were effective, provided ideas for fine-tuning the delivery of the program, described this program as supporting their children’s nutrition. Full article

Background: Parents caring for preterm infants during hospital admission have unique needs. How these are addressed plays an important role in parents’ ability to cope with caregiving responsibilities. Educational programmes have proven beneficial to parents during their infant’s stay in the neonatal intensive care unit (NICU), for both parental and neonatal outcomes. Key components of parenting education during the NICU stay have been described; however, less is known about our understanding of parents’ educational needs, specifically in the South African context. Objectives: To explore parental needs and perceptions regarding a parenting education intervention provided to them while in the NICU, with a focus on programme content, structure, and mode of delivery. Methods: Three focus group discussions were conducted with mothers of preterm infants admitted to the NICU of a referral hospital in the North West province, South Africa. Inclusion criteria comprised parents of infants born in the hospital, singletons or multiples, with a gestational age below 37 weeks, and expected to stay in the NICU for at least 7 days. Discussions centred on mothers’ perceived needs regarding parenting education based on their experiences during their baby’s NICU admission. Results: Twenty-five mothers of singletons or multiples born before 37 weeks of gestation participated in the study. Three main themes were identified: (1) preference for content topics to include basic infant care, infant health and behaviours, and post-discharge related information; (2) education programme structure, which included instructional approaches and training logistics; and (3) support needs, including intrapersonal motivators, communication, and psychosocial and physical support. Conclusions: Participants recognised educational content needs that align with existing literature. However, they also emphasised the importance of addressing basic physical and emotional needs while receiving educational content, ensuring that parents feel empowered and capable of engaging with the information. Full article

The adult child–parent relationship is a key source of emotional support across adulthood and older age. This study takes a dyadic, attachment-based perspective to examine how (dis)similarities in attachment orientations between older parents and adult children relate to the emotional support they provide each other. A total of 104 adult child–parent dyads (M parents’ age = 67.85; M adult children’s age = 36.18) participated. Structural Equation Modeling (SEM) and Response Surface Analysis (RSA) were used to assess how dyadic (dis)similarities in attachment anxiety and avoidance are associated with own support provision. Both parents and adult children provided greater emotional support when their attachment insecurity was at low levels. Support also increased when the partner showed higher insecurity but differed across generations: parents offered more support when the child’s anxiety or avoidance exceeded their own, even at own high levels of insecurity, whereas children supported insecure parents only when their own insecurity was relatively low. Attachment-based processes in the adult child–parent bond serve as a source of emotional connection, operating differently across generations: parents can adapt caregiving to meet children’s needs, while children’s support is more constrained by their own attachment insecurity. Full article

Dementia is a progressive condition that affects cognition, communication, mobility, and independence, posing growing challenges for individuals, caregivers, and healthcare systems. While traditional care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability. We propose a research and innovation roadmap to guide the responsible development, validation, and dissemination of AI technologies that are adaptive, inclusive, and centered on individual well-being. By advancing this framework, we aim to promote equitable and person-centered dementia care that evolves with individuals’ changing needs. Full article

Background/Objectives: Inclusive nutrition services and data on children with disabilities living in low- and middle-income countries remain limited. We estimated the prevalence of undernutrition and described feeding practices and difficulties among children with disabilities ages birth to 10 years at a rehabilitation hospital in Uganda and identified barriers and opportunities for inclusive nutrition. Methods: This cross-sectional study enrolled 428 children. Data included demographics, weight, height, mid–upper arm circumference (MUAC), hemoglobin levels, risk for feeding difficulties, caregiver-reported feeding practices, and functional difficulties complemented by 32 caregiver and stakeholder interviews. Undernutrition was defined using WHO z-scores, MUAC, and anemia cutoffs. Associations were examined using Pearson’s chi-squared tests and adjusted odds ratios from logistic regression. Results: Over half of participants were boys (56.1%) and 65.9% were <24 months old. Common conditions included cleft lip/palate (55.4%) and cerebral palsy (38.6%). Undernutrition was prevalent: 45.2% were underweight, 38.3% stunted, 16.1% wasted (by MUAC), and 39.5% anemic. Being at risk for feeding difficulties (67.2% of children) increased the odds of underweight [AOR = 2.28 (1.23–4.24)], stunting [2.46 (1.26–4.79)], and wasting [2.43 (1.10–5.35)] after adjusting for covariates. Bottle-feeding increased the odds of stunting [3.09 (1.24–7.70)] in infants with cleft lip/palate < 12 months old. Poor access to services, food insecurity, and feeding challenges were key barriers to optimal nutrition. Most caregivers reported using practices that support responsive feeding. Conclusions: Reported barriers to services and high levels of undernutrition, strongly linked to feeding difficulties, underscore the need for targeted feeding interventions and better access to inclusive nutrition services in Uganda. Full article

Background/Objectives: Family members are the principal providers of home-based care for migrant older adults. Linguistic, cultural, and structural barriers within health systems exacerbate the caregiver burden across emotional, physical and financial domains. Although home healthcare services may alleviate this burden, variability in access, cultural safety, and care coordination can also intensify it. This scoping review maps the evidence on the burden experienced by family caregivers who deliver home-based healthcare to migrant older adults and examines how these arrangements affect caregivers’ health and well-being. It synthesizes the literature on facilitators and barriers—including access, cultural-linguistic fit, coordination with formal services, and legal/immigration constraints—and distills implications for policy and practice to strengthen equitable, culturally responsive home care. Method: The Joanna Briggs Institute (JBI) scoping review framework was used to conduct the review. A comprehensive search was performed across six databases (CINAHL, Scopus, Web of Science, PsycINFO, MEDLINE and Sociological Abstracts) for articles published between 2000 and 2025. Studies were selected based on predefined inclusion criteria focusing on the family caregiver burden in providing home healthcare for migrant older adults. Data extraction and thematic analysis were conducted to identify key themes. Results: The review identified 20 studies across various geographical regions, highlighting four key themes: (1) Multidimensional Caregiver Burden, (2) The Influence of Gender, Family Hierarchy, and Migratory Trajectories on Caregiving, (3) Limited Access to Formal and Culturally Appropriate Support, and (4) Health Outcomes, Coping, and the Need for Community-Based Solutions. Conclusions: System-level reforms are required to advance equity in home healthcare for aging migrants. Priorities include establishing accountable cultural-safety training for providers; expanding multilingual access across intake, assessment, and follow-up; and formally recognizing and resourcing family caregivers (e.g., navigation support, respite, training, and financial relief). Investment in community-driven programs, frameworks and targeted outreach—co-designed with migrant communities—can mitigate isolation and improve uptake. While home healthcare is pivotal, structural inequities and cultural barriers continue to constrain equitable access. Addressing these gaps demands coordinated policy action, enhanced provider preparation, and culturally responsive care models. Future research should evaluate innovative frameworks that integrate community partnerships and culturally responsive practices to reduce the caregiver burden and improve outcomes for migrant families. Full article

Background/Objectives: The Rett Syndrome Behavior Questionnaire (RSBQ) is a widely used caregiver-reported instrument for assessing behavioral and neurological features of Rett syndrome (RTT). However, a validated Korean version has not been available. This study aimed to translate the RSBQ into Korean (K-RSBQ) and to evaluate its psychometric properties in a Korean RTT population. Methods: The RSBQ was translated and back-translated using standardized procedures and refined through a Delphi process. Primary caregivers of individuals with clinically diagnosed RTT completed an online survey including the K-RSBQ and the Childhood Autism Rating Scale (CARS). Test–retest reliability was assessed in a subset of caregivers who completed the questionnaire twice within one week, and inter-rater reliability was evaluated when an additional caregiver was available. Results: Sixty-six primary caregivers participated. The K-RSBQ demonstrated high internal consistency for the total score (Cronbach’s α = 0.912) and moderate-to-high consistency across most subscales. Test–retest reliability for the total score was moderate (weighted κ = 0.594), while inter-rater reliability between primary and secondary caregivers was generally low. The hand behavior subscale showed low and non-significant test–retest reliability. The K-RSBQ total score exhibited a low-to-moderate correlation with the CARS total score, and the general mood subscale showed a moderate correlation with the CARS emotional response item. Caregivers reported minimal difficulty in understanding the questionnaire items. Conclusions: The K-RSBQ demonstrates acceptable internal consistency and test–retest reliability when administered to primary caregivers, with preliminary evidence supporting its construct validity. Although limitations exist regarding criterion validation and inter-rater agreement, the K-RSBQ represents a feasible and culturally adapted tool for assessing RTT-related behavioral features in Korean clinical and research settings. Full article

Women play a key role in Greek olive cultivation, a sector at the heart of local economies currently facing increasing pressures from climate change. This study explores gender roles, responsibilities, and access to resources shaping the adoption of sustainable agriculture practices. Through in-depth interviews with female farmers on the island of Crete, the results show that women face limited access to training and financial services as well as gender-based discrimination and the hidden caregiving and house working tasks. However, they manifest a strong openness towards sustainable practices, driven by environmental values, even among those lacking decision-making authority. Despite these challenges, women show a positive attitude toward learning and innovation, calling for more institutional support and training opportunities. This study sheds light on the need for recognition of women’s roles in agriculture, particularly in the context of climate adaptation, and offers practical recommendations to improve gender roles within the olive sector. Full article

Multiple sclerosis (MS) is a chronic, heterogeneous, multifactorial, immune-mediated neurodegenerative disease of the central nervous system that affects the working-age population. Its development is influenced by both genetic and environmental factors. A pathological hallmark of MS is the formation of demyelinating lesions in the brain and spinal cord, which are associated with neuronal damage caused by autoaggressive immune factors (T cells, B cells, and myeloid cells). Focal lesions are believed to be caused by the infiltration of immune cells into the central nervous system (CNS) parenchyma with concomitant tissue damage. Multiple sclerosis represents a significant social problem due to the high cost of available treatments, as well as the deterioration of employment prospects and job retention for both patients and their caregivers. Advances in MS diagnostic methods have enabled disease detection at early stages and correction of immune response impairments. Concurrently, treatments for MS patients are actively being studied, with the ongoing development of novel methods for targeted and cellular immunotherapy. This review primarily discusses approaches to cellular immunotherapy and methods of influencing the cellular arm of immunopathogenesis in multiple sclerosis. Full article

Background/Objectives: Caregivers of infants with congenital muscular torticollis (CMT) frequently seek information online, although the accuracy, clarity, and safety of web-based content remain variable. As large language models (LLMs) are increasingly used as health information tools, their reliability for caregiver education requires systematic evaluation. This study aimed to assess the reproducibility and quality of ChatGPT-5.1 responses to caregiver-centered questions regarding CMT. Methods: A set of 17 questions was developed through a Delphi process involving clinicians and caregivers to ensure relevance and comprehensiveness. ChatGPT generated responses in two independent sessions. Reproducibility was assessed using TF–IDF cosine similarity and embedding-based semantic similarity. Ten clinical experts evaluated each response for accuracy, readability, safety, and overall quality using a 4-point Likert scale. Results: ChatGPT demonstrated moderate lexical consistency (mean TF–IDF similarity 0.75) and high semantic stability (mean embedding similarity 0.92). Expert ratings indicated moderate to good performance across domains, with mean scores of 3.0 for accuracy, 3.6 for readability, 3.1 for safety, and 3.1 for overall quality. However, several responses exhibited deficiencies, particularly due to omission of key cautions, oversimplification, or insufficient clinical detail. Conclusions: While ChatGPT provides fluent and generally accurate information about CMT, the observed variability across topics underscores the importance of human oversight and content refinement prior to integration into caregiver-facing educational materials. Full article

Background/Objectives: While nurses showed a willingness to work during the pandemic and wartime, little is understood about how they managed the conflict between their roles as caregivers and personal or family obligations. They are deemed “essential workers,” risking their safety to fulfill their duties. Objectives: This study aims to explore the lived experience of nurses during COVID-19 and wartime, delving deeper into their emotional and moral experiences, providing insights for nurses and nursing management about how nurses negotiate dilemmas. Methods: A focused interpretive, hermeneutic, phenomenological approach was employed. From December 2022 to January 2023, ten hospital-based nurses from two hospitals were purposively sampled for in-depth, semi-structured interviews, which were transcribed and analyzed. The study was approved by the University Ethics Committee (31102022). Results: The essence of “ Moral Conflicts of Dual Identity and Dual Allegiance” revealed profound moral and emotional struggles among nurses. Four key themes emerged: (1) Moral Stressors and Identity Negotiation, (2) Competing Responsibilities and Ethical Double-binds, (3) Virtual and Practical Wisdom in Crises, (4) Responses of Stress and Erosion of Support Conclusions: Understanding nurses’ ethical dilemmas is essential for healthcare leadership. Leaders must make it a priority for workplace safety for their nurses. In wartime, it is not obvious that the workplace is unsafe; leaders must foster open dialog and support systems in response to these crises. This study highlights the significance of peer support, emphasizing the need for policies that address the complex moral challenges nurses face daily. Full article