Search Results (53)

Background/Objectives: The Caregiver Wellness: U-Model Questionnaire offers a self-guided approach to assessing caregiver well-being and provides resources designed to empower caregivers to embrace self-care. The instrument consists of 27 items organized into nine wellness dimensions: occupational wellness, physical wellness, psychological wellness, intellectual wellness, social wellness, resilience, empowerment, spiritual wellness, and financial wellness. The purpose of this study was to evaluate the validity and reliability of the Caregiver Wellness: U-Model Questionnaire for measuring the perceived well-being of caregivers. Methods: This secondary analysis used a convenience sample of 225 participants who completed the questionnaire between 2022 and 2025; family caregivers and frontline direct care workers could not be distinguished within the dataset. Analyses of the CWQ included internal reliability consistency, exploratory factor analysis (EFA) and subscale correlations for model and subscale refinement. Results: McDonald’s omega (0.828) indicated high reliability of the CWQ. The EFA revealed six factors retained on Eigenvalues > 1 and visual inspection of a scree plot. Subscale correlations showed evidence of convergent validity. The original nine subscale questionnaire items were mapped to the corresponding six factors from the structure matrix. The resulting six subscales are Connected Well-Being, Personal Agency, Empowered Adaptive Capacity, Functional Capacity, Resilient Self-Regulation, and Occupational Wellness. Conclusions: The findings of this study and the revised six-factor Caregiver Wellness model demonstrate an improved understanding of caregiver wellness as an interplay of relational connectedness, personal empowerment, adaptive resilience, functional resources, self-regulatory processes, and occupational fulfillment. Full article

Bedtime procrastination is defined as delaying sleep despite having no external obstacles. It is a well-established marker of impaired self-regulation and contributes to sleep loss, daytime fatigue, and emotional dysregulation. A parental variant of this behavior is termed parental revenge bedtime procrastination (RBP). This behavior is conceptualized as an autonomy-motivated subtype in which caregivers reclaim personal time at night to compensate for daytime caregiving demands. However, parental RBP has received almost no direct empirical attention, particularly regarding its impact on parent–child interaction quality. Concurrently, distinct literatures on parental technoference, sensitivity, and responsive feeding converge on a shared theme. A sleep-deprived, depleted, and phone-absorbed parent may struggle to read and respond to a young child’s hunger and satiety cues during meals. Grounding these relational dynamics in classical infant mental health frameworks highlights the developmental stakes of impaired mealtime reciprocity. Key theoretical foundations include Daniel Stern’s theory of affective attunement, Infant Research paradigms by Beebe and Tronick, contemporary neurocognitive models, and Irene Chatoor’s clinical classification of feeding disorders. To our knowledge, no study has tested this direct chain in children aged 0–3 years. This perspective article maps existing evidence onto a conceptual model linking parental RBP to feeding interaction quality. It identifies empirically supported segments versus inferential links, proposes a concrete research agenda, outlines potential clinical implications, and advocates for the systematic investigation of this pathway. Full article

With an aging demographic and increasingly stretched care services in many countries, the issue of unpaid care for older adults is a growing concern for families and policy makers alike. Empirical evidence highlights how unpaid caregiving can be a stressful and challenging experience. In this paper, we draw from and build on the stress process model, which conceptualizes caregiver well-being and mental health as outcomes of primary and secondary stressors within social context, as well as relational framing from intersectional life course theory and feminist political economics. Based on 57 in-depth interviews with unpaid caregivers for older adults across Canada, we articulate two non-mutually exclusive themes that add nuance to understandings of caregiver stress. First, many caregivers describe their caregiving in “plateaus and peaks,” with minimal stress much of the time and spikes in stress at moments of crisis and transition. However, there are outlier cases of chronically stressed carers, with evidence that gender, socioeconomic status and complex care situations inequitably shape caregiver experiences. Second, some care journeys involve “loops,” with care for one senior ending, followed by care for another beginning shortly thereafter, a novel articulation of multiple care which was found to influence caregiver decisions and meaning-making about care. Full article

Background: Due to the rise in Alzheimer disease (AD) and AD-related dementias (AD/ADRD) in an aging population, millions of caregivers will be at risk for physical and mental health decline. As those they care for already have physical and cognitive impairment, it is crucial that caregivers maintain health-promoting behaviors. Because regular physical activity (PA) prevents functional loss and improves physical health and well-being, understanding how to help caregivers adopt and sustain PA despite unique time, caregiving, and self-efficacy barriers is a pressing public-health priority. Existing health-promoting interventions among dementia caregivers, including PA, have demonstrated limited success. To overcome the fragmentation and slow synthesis of behavioral science evidence, the Human Behavior-Change Project advocates theoretical grounding, systematic mapping of intervention components (e.g., behavior change techniques [BCTs]) using standardized taxonomies, and explicit specification of mechanisms of behavior change (MoBCs). Objective: To examine the limited success of health-promotion interventions among dementia caregivers we aimed to conduct a narrative review to synthesize evidence from interventions that evaluated PA in dementia caregivers across three domains: (1) use of behavioral theory to inform intervention design, (2) specification of BCTs, and (3) identification and measurement of MoBCs. Methods: Two scientific databases were searched to identify representative studies and reviews, using key terms including “physical activity”, “intervention”, “dementia”, and “caregiver” from inception to July 2025. Results: Seven primary intervention trials and six reviews were selected for inclusion. Gaps across the domains were identified to inform priority areas for future research. Conclusions: There is a need to develop tailored, theory-driven PA interventions that target empirically supported BCTs and MoBCs to improve dementia caregivers’ health and well-being. Full article

Background/Objectives: Family caregiving for people living with dementia is central to ageing and long-term care, but it is not only a practical arrangement but also a relational and structurally shaped experience. Care may be grounded in affection, responsibility, and connection, while still becoming difficult to refuse, share, or limit. Although caregiver burden is well documented, less is known about how former caregivers retrospectively appraise the caregiving role after active care has ended. This study examined role captivity among former family caregivers, focusing on constrained choice, subjective role engulfment, perceived support, and caregiver wellbeing. Methods: A retrospective cross-sectional mixed-methods survey was conducted among 180 former family caregivers of people living with dementia in Northern Italy. Quantitative analyses examined associations between role-captivity-related indicators and retrospective caregiving outcomes. Open-ended responses were analysed using theory-informed qualitative content analysis. Results: Constrained choice at caregiving uptake was reported by 22.2% of participants, and 56.1% met the criterion for subjective role engulfment. Overall, 60.0% would provide family care again, while only 28.3% would be willing to receive family care themselves. One in five reported caregiving-related health problems. In multivariable models, constrained choice was associated with lower willingness to provide care again (OR = 0.27, p = 0.002) and less positive retrospective appraisal (OR = 0.35, p = 0.036). Subjective role engulfment was independently associated with less positive appraisal (OR = 0.36, p = 0.008), while perceived support was associated with positive appraisal (OR = 6.31, p < 0.001) and perceived processing (OR = 2.68, p = 0.013). Qualitative findings showed that caregiving was often remembered as meaningful and relationally important, yet difficult to refuse, progressively all-consuming, and shaped by structural and informational barriers. Conclusions: Retrospective appraisal of family dementia caregiving depends not only on care demands, but also on whether care was experienced as chosen, bounded, shared, and supported. Role captivity helps identify when relationally meaningful care becomes difficult to sustain and highlights the need for caregiver-sensitive dementia care that protects agency, role boundaries, and access to timely support. Full article

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders among children and is associated with significant behavioral, academic, and social challenges. Caregiver-focused behavioral interventions have gained increasing attention as effective non-pharmacological approaches for improving child outcomes and enhancing parental management skills. Thus, this study aimed to evaluate the potential effectiveness of behavior change wheel (BCW)-based nursing intervention in improving maternal behavioral management practices, as well as child outcomes involving ADHD symptoms among preschool children aged 3–6 years with attention-deficit/hyperactivity disorder. Methods: A one-group pretest–posttest quasi-experimental design was conducted among 55 mothers and their children diagnosed with ADHD at Thawat Center and King Abdullah Center for Disability Services in Jeddah, Saudi Arabia. The study did not include a control group. Participants were recruited using a convenience sampling technique. Data were collected using a sociodemographic questionnaire, ADHD Rating Scale IV—Preschool Version, the BCW Intervention Compliance Questionnaire, and the Parental Knowledge and Attitude Questionnaire. The intervention was implemented over eight weeks and included educational sessions, behavioral skills training, motivational enhancement, role-play activities, and follow-up reinforcement. Results: The preliminary findings from the one-group pre/posttest quasi-experimental study revealed statistically significant improvements in children’s inattentive and hyperactivity symptoms following the intervention (p < 0.001). Mothers also demonstrated significant improvements in perceived knowledge, attitudes, and compliance with BCW components after program implementation (p < 0.001). The proportion of mothers with satisfactory perceived knowledge increased from 21.8% pre-intervention to 94.5% post-intervention, while positive attitudes increased from 23.6% to 98.2%. In addition, compliance with BCW components improved from 30.9% before the intervention to 94.5% after implementation. Conclusions: The BCW-based nursing intervention was associated with pre–post improvement in maternal caregiving outcomes and reduced ADHD symptoms among preschool children. These preliminary findings from the one-group pretest–posttest quasi-experimental study suggest the potential value of theory-informed, caregiver-focused nursing interventions in pediatric and community healthcare settings. However, due to the one-group pretest–posttest design without a control group, causal inferences cannot be made. Further controlled studies are needed to confirm these associations and establish causal inferences. Full article

Background/Objectives: Recognizing and managing grief is particularly important in nursing, especially from the perspective of family caregivers. In this qualitative study, we aim to understand the grieving process of family caregivers, focusing on what happens before the death of an adult family member due to chronic illness, and to identify the factors influencing the grieving process in this context. Methods: This study is an outcome of a broader study which aimed to understand how family caregivers grieve during the first year following the death of an adult family member due to a chronic illness. This article will only address the influencing conditions that emerged from data related to events that occurred prior to the person’s death. A theoretical sample was gathered through semi-structured interviews with 20 bereaved family caregivers. Data were collected and then analyzed independently by the research team using the three stages and principles of Strauss and Corbin’s grounded theory. Results: Adaptation was identified as the central category. Before death, the family caregiver undergoes two adaptive processes: adapting to their new role and preparing for the imminent loss. As they adapt to this loss, they become aware of the seriousness of the illness and the inevitability of death, opening the possibility for the grieving process to begin. The process is influenced by personal and contextual factors as well as interaction-related factors, including access to information, satisfaction with the care provided, recognition of their efforts, and feelings of abandonment or interaction with healthcare professionals. A wide range of emotions and feelings are experienced. This experience is colored by hope and anticipatory grief. The meaning of the dying process is explored and expectations are redefined. Conclusions: The grieving process experienced by family caregivers is an adaptive process that begins before the patient’s death. Some conditions can be modified before the patient’s death; in this case, nurse interventions can enhance the experience of family caregivers. Full article

Parental identity, the extent to which individuals integrate parenting roles into their self-concept, is associated with subjective well-being (SWB). However, research has largely focused on current parents, with limited attention to those with alternative caregiving roles. Companion dogs often act as caregiving figures, but their role in shaping identity and well-being processes has not been fully explored. This cross-sectional, survey-based study examined whether parental identity is associated with SWB, regardless of parental status, and whether the human–dog bond moderates any association in older women. Women dog owners aged 40 years and over (N = 296, M age = 51.6) completed an online survey including the Parental Identity and Enjoyment Scale, the Dog Owner Relationship Scale, the Satisfaction With Life Scale, and the Flourishing Scale. Parental identity was positively associated with life satisfaction, r = 0.38, p < 0.001, and flourishing, r = 0.23, p < 0.001, and moderated regression models were significant for both (p < 0.001). However, interaction effects between parental identity and the human–dog bond were not significant. These findings extend identity theory, demonstrating that parental identity predicts SWB across diverse pathways and independently of parental status. The results contribute to emerging research on caregiving identities and highlight the importance of considering identity processes, rather than parental status alone, when examining well-being in older women. Full article

Background: Parents of preterm infants face significant emotional, informational, and caregiving challenges during neonatal intensive care unit (NICU) hospitalisation. Educational interventions are increasingly used to support parental readiness; however, considerable variation exists in their content, structure, and delivery. A clearer understanding of these components is essential to inform the development of effective, contextually responsive programmes. Aim: To identify and synthesise the core educational components, programme structures, and embedded parental support needs within NICU-based educational interventions for parents of preterm infants. Methods: A systematic search of peer-reviewed literature (January 2010–September 2022) identified 33 studies of high methodological quality. Data were extracted and synthesised using thematic analysis. Results: Three overarching domains were identified: (1) educational content, (2) programme structure and delivery, and (3) parental support needs integrated within educational delivery. The educational content encompassed the NICU environment, infant health and behaviour, caregiving practices, parental well-being, and discharge preparation. Programme structures varied widely in terms of intensity, duration, delivery modality, and facilitator roles, with limited justification for structural choices. Parental support–emotional, relational, and confidence-building–was inconsistently embedded despite evidence of its importance. Established interventions such as COPE, FICare, and FCC have clearer theoretical foundations and more holistic support than most locally developed programmes. Conclusions: NICU educational interventions positively influence parental knowledge, confidence, and parent–infant interaction; however, substantial variation and limited conceptual grounding hinder their comparability and scalability. The evidence base remains dominated by high-income settings, which limits its global applicability. Future research must prioritise theory-informed design, transparent reporting, and context-sensitive adaptation, particularly in under-resourced health systems, to support equitable and effective parental education for families of preterm infants worldwide. Full article

This article examines how Turkey’s 2024 amendment to the Animal Protection Law reshapes volunteer caregiving for free-roaming dogs in Istanbul by reconfiguring the practical conditions under which care is sought, coordinated, and sustained. Drawing on 43 in-depth interviews and five months of fieldwork (1 July–30 November 2025), this study combines constructivist grounded theory with reflexive thematic analysis to trace how legal change is encountered through everyday governance interfaces and how these encounters reorganize caregivers’ routines, capacities, and moral worlds. The analysis yields four interlocking findings. First, caregivers describe a temporality of “living in pre-loss,” in which anticipated removal, disappearance, and uncertain outcomes generate chronic vigilance, anticipatory grief, and ambiguous loss without closure. Second, caregiving is increasingly recalibrated as risk management: commitments persist, but intervention narrows through heightened exposure to complaints, reputational scrutiny, and fears that help-seeking may backfire. Third, institutional pathways—hotlines, shelter intake, and municipal responses—are experienced as discretionary and opaque, producing a fluctuating threshold between assistance and harm that conditions whether caregivers engage official systems at all. Fourth, this study identifies a recurring veterinary bottleneck at the street–clinic–recovery handover, where limited short-term holding capacity stalls treatment trajectories and displaces recovery labor into precarious domestic and informal spaces. Together, these findings argue that caregiver well-being is not ancillary to animal welfare governance but constitutive of it. It shapes the continuity of monitoring, the timeliness of intervention, and the everyday mediation through which coexistence is maintained under intensified legal and political pressure. Full article

Remote and hybrid teaching have become enduring features of European higher education, yet their implications for teachers’ well-being are often examined in fragmented ways. This study investigated a systemic imbalance across five interdependent domains—physical, emotional, cognitive, social, and existential well-being—among Lithuanian higher education teachers, interpreted through the Job Demands–Resources framework and Self-Determination Theory. Using a mixed-methods design, data were collected from 385 teachers via a structured online questionnaire that included demographic variables, 10-point imbalance ratings across the five domains, and open-ended questions. Quantitative analyses (descriptive statistics and correlational pattern exploration) were complemented by thematic analysis of teachers’ narratives. Results indicate a widespread multidimensional disruption: elevated stress and emotional exhaustion, substantial physical strain associated with inadequate home workspaces, cognitive overload linked to multi-platform teaching, reduced collegial connection, blurred work–life boundaries, and challenges to professional meaning. Strain was unevenly distributed, with higher vulnerability associated with gender and caregiving demands, early-career status, limited ergonomic conditions, and weak institutional support. The findings support a systemic interpretation in which intensified demands, reduced resources, and frustrated psychological needs jointly drive well-being imbalance. Sustainable remote/hybrid teaching therefore requires institution-level measures (workload regulation, training, ergonomic support, and boundary-setting policies) rather than reliance on individual coping alone. Full article

Out-of-school time (OST) STEM programs are well-positioned to strengthen family engagement, yet practical, theory-aligned tools remain limited. This early-stage mixed-methods study tests parent/caregiver (P/C) and staff (S) surveys based on Clover for Families developmental theory expressed through the CARE framework: Connect (welcoming climate, clear communication), Act (hands-on participation, at-home supports), Reflect (shared meaning-making, feedback), and Empower (family voice, decision-making). Nine OST STEM programs (eight U.S. states) co-designed/piloted CARE plans, activities, and surveys over six months. Quantitative data included baseline experiences (CARE practice frequency; n = 67 P/C, 42 S across nine programs), program-end reflection (retrospective perceptions of change; n = 26 P/C, 29 S), and forced-ranking (most/least important domains; n = 67 P/C, 42 S). Qualitative data from meetings, open responses, and interviews were analyzed to contextualize quantitative findings, which included strong internal consistency (P/C α = 0.83–0.95; S α = 0.77–0.95) and large retrospective gains in both groups across domains. Forced-ranking elevated Connect and Act over Reflect and Empower, highlighting a need to scaffold family involvement. Staff described CARE as useful and actionable. Findings show that CARE supports measurement and continuous improvement of STEM family engagement. Future work should test large-sample validity, link results to observed practice and youth outcomes, and refine Empowerment-related items for everyday agency. Full article

This perspective advances a psychoanalytic—embodiment account of the “libido of generativity” (LoG)—future-oriented reorganization of erotic desire that links embodied arousal with caregiving, legacy, and shared projects. We define LoG along four axes (direction of investment: dyad↔triad; temporal horizon: immediacy↔future; outcome modalities: procreative, creative–sublimative, community-forming; affective regulation: shame/guilt↔pride/gratitude). Integrating interoception, body ownership/agency, and self-compassion with reproductive mentalizing, we specify three proximal levers—embodiment, affect regulation, and representation—through which sexual mindfulness can recalibrate bodily salience, blunt shame-based self-objectification, and expand triadic representations (self–partner–child/symbolic offspring). We then translate these mechanisms into a brief, practice-ready relationship guidance (RG) curriculum (6–8 sessions) combining somatic mindfulness, compassion micro-practices, reproductive-mentalizing dialogs, communication skills, and generative rituals. We articulate falsifiable propositions (e.g., mindfulness → ↑couple satisfaction via ↓body-image self-consciousness and ↑reproductive mentalizing) and a sex/gender-attentive reporting plan (SAGER). Primary outcomes include sexual functioning/satisfaction and couple satisfaction/communication; secondary mechanistic endpoints index interoceptive accuracy/awareness (including heartbeat-evoked potentials), self-compassion, and reproductive mentalizing. By aligning contemplative practices with couple-skills training and equity-focused implementation, the LoG framework offers a testable bridge from psychoanalytic theory and embodiment science to measurable improvements in sexual health and couple well-being. Full article

At present, the design of autism rehabilitation centers in China generally fails to meet the rehabilitation needs of patients, making it difficult to achieve the health and well-being goals of sustainable development. In this context, restorative environment theory, with its potential to improve spatial environments and enhance well-being, has gradually become a key driving force in the environmental design process. Therefore, this literature review employs a combined approach of macro-level quantitative and micro-level qualitative research methods based on the Web of Science (WOS) database. First, 5953 relevant literature sources were analyzed to reveal the research background, current status, hot topics, and future development trends of the theory of restorative environment and rehabilitation centers for children with autism. Through keyword network visualization, seven primary clusters were identified: #0 environmental design, #1 burnout, #2 Autism specturn disorder, #3 Attention deficit hyperactivity disorder, #4 caregiver, #5 domiciliary care, # 6 stroke. These clusters were further synthesized into four core design elements: lifecycle-spanning design, family collaboration and community engagement design, green sustainable environment design, and culturally inclusive and diverse physical and mental development design. Subsequently, a multi-level case analysis was conducted using 24 global autism-friendly design examples to validate the practical applicability of these core elements. Finally, based on the research findings, the discussion section proposes environmental design strategies for autism rehabilitation centers tailored to the Chinese context.These strategies aim to enhance the well-being of children with autism and contribute to the achievement of Sustainable Development Goal 3 (SDG3). Full article

Caregivers of a child with a serious medical condition are often confronted with difficult and stressful medical information. While they commonly seek out health-related information to better care for their child and help with their decision-making, sometimes caregivers engage in healthcare information avoidance. Healthcare information avoidance is the decision to prevent or delay the acquisition of available, but potentially unwanted, health-related information. We begin by defining the construct of healthcare information avoidance and exploring key theoretical frameworks that illuminate its underlying mechanisms including emotion regulation theory, attentional and cognitive models, approach-avoidance coping strategies, and dispositional theories. A lack of validated measures to assess caregiver healthcare information avoidance was noted as contributing to the dearth of empirical work in this area. Common areas of caregiver healthcare information avoidance were identified at various points throughout the pediatric palliative care illness trajectory. The review concludes with directions for future research and practical recommendations for clinical care, highlighting the importance of identifying the occurrence and reasons for caregiver information avoidance as well as optimizing approaches to information provision. Full article