Search Results (73)

The global population aged 65 and older is expected to double from 761 million in 2021 to 1.6 billion by 2050. Despite often being treated separately in clinical practice and policy, oral health and mental health are fundamentally interconnected in older adulthood, forming a bidirectional relationship that exacerbates disability, social inequity, and systemic healthcare challenges. This narrative review aims to summarize the two-way relationship between mental and oral health and emphasize their combined impact on systemic health, social engagement, and independence among ageing populations. The bidirectional relationship has profound clinical significance. Untreated oral diseases induce chronic pain and cause social embarrassment, aggravating pre-existing depression and anxiety. Periodontal disease can worsen systemic conditions such as diabetes, cardiovascular disease, and dementia via a shared inflammatory pathway. Conversely, mental health issues—including depression, anxiety, cognitive decline, and the use of psychotropic medications—reduce motivation for oral care, prompt dental neglect, and affect salivary function, deteriorating oral health. Despite clear connections, systemic gaps persist, including fragmented healthcare systems, financial barriers, stigma, lack of awareness, and caregiver burnout. To address these challenges, strategies such as developing integrated care models to unify dental and mental health services, reforming policies to prioritize oral and mental health parity, advocating anti-stigma campaigns to clear the misconceptions, and implementing community-based healthcare programmes to reach underserved older adults are essential. By recognizing oral health as a vital component of mental resilience, societies can transform ageing into an era of empowered well-being, where the mouth–mind connection promotes holistic health rather than functional decline. 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

Background/Objectives: Family members who provide care play a central but often underestimated role in the healthcare system and are frequently exposed to considerable physical, emotional, and social stress. To better understand and support their needs, a structured self-assessment tool (SSA-PA) was developed. This development addresses the current lack of practical, validated instruments that enable caregivers to systematically reflect on their own stress levels and resources, which is becoming increasingly important in view of the growing demand for care and the risk of caregiver burnout. This tool aims to promote self-reflection, identify individual stresses and resources, and enable more targeted support for family caregivers. Methods: The development process (September–December 2024) followed a multi-phase design that integrated theoretical foundations from nursing, health, and psychology, in particular Orem’s theory of self-care deficit, Lazarus and Folkman’s stress and coping model, and Engel’s biopsychosocial model. Four core dimensions were defined: (1) health and self-care, (2) burden and stress, (3) support and resources, and (4) satisfaction and quality of life. The final tool comprises 37 items (mostly 5-point Likert scales), supplemented by multiple-choice and open-ended questions. Content validity was ensured through expert review and testing with nine family caregivers. Internal consistency was assessed using Cronbach’s alpha (α = 0.998), indicating very high reliability, although possible item redundancies were identified. The evaluation took place in January 2025 with 33 family caregivers to assess user-friendliness, relevance, and perceived usefulness. Results: The majority of participants rated the tool as user-friendly and clearly structured. Around 80% reported a high level of comprehensibility, and over half stated that the tool provided new insights into their own health and care burden. Qualitative feedback highlighted the value of the tool for self-reflection and motivation to seek external support. Suggestions for improvement included shorter item formulations, improved visual feedback (e.g., progress bars or charts), and expanded question areas on financial burdens and digital support options. Conclusions: The SSA-PA is a theoretically grounded and user-centered tool for assessing and reflecting on the situation of family caregivers. It not only enables systematic self-assessments but also promotes awareness and proactive coping strategies. Future research should focus on conducting factor analyses to further validate the construct, testing the tool in larger samples, and exploring its integration into structured care consultations to improve the quality of home care. Full article

Background and Objectives: We examined how health-related quality of life (HRQoL) in children with congenital heart disease (CHD) and caregiver stress/burnout relate in terms of lesion severity. Methods: We enrolled 72 child–caregiver dyads at a tertiary centre (May 2023–April 2025). Children completed PedsQL and CDI (anxiety assessment via SCARED-C was descriptive and not modelled in APIM); caregivers completed SF-36, PSS-10, and the Parental Burnout Assessment (PBA). Lesion severity (mild n = 22, moderate n = 34, severe n = 16) and LVEF were abstracted. Pearson correlations and actor–partner interdependence models (APIM) estimated within- and cross-partner effects. Results: Child PedsQL decreased with severity (mild 81.2 ± 7.4; moderate 70.9 ± 8.1; severe 63.3 ± 5.1; p < 0.001); caregiver SF-36 Mental Component Summary (MCS) showed a parallel gradient (66.8 ± 9.2; 59.7 ± 8.5; 54.1 ± 7.9; p < 0.001). Child HRQoL correlated with caregiver MCS (r = 0.46) and inversely with caregiver stress (PSS r = −0.42) and burnout (PBA r = −0.39). In APIM, caregiver stress predicted a caregiver’s own MCS (actor β = −0.38, p < 0.001) and the child’s PedsQL (partner β = −0.26, p = 0.002); higher child depressive symptoms predicted lower caregiver MCS (partner β = −0.22, p = 0.006). Each step up in lesion severity independently reduced child PedsQL by 7.9 points and caregiver MCS by 5.3 points (both p < 0.001). Dyads with unscheduled hospitalizations (n = 43) had poorer scores in both members. Conclusions: Psychological wellbeing in CHD dyads is strongly interdependent; caregiver stress relates to lower child HRQoL and child mood to caregiver mental health. Brief dyadic screening (PedsQL/SF-36 with PSS/CDI) and integrated, family-focused interventions may better target high-risk families, particularly with severe lesions or recent hospitalizations. Full article

Background/Objectives: Home healthcare assistants (HHCAs) play a vital role in supporting older adults to remain in their homes. Yet, this work is often performed under conditions of emotional strain, limited resources, and systemic undervaluation. This study answers the question, how do HHCAs cope with work-related stress? Methods: Undertaken during the COVID-19 pandemic, a period of heightened stress and mandated social distancing, online interviews were conducted with HHCAs (n = 10). Data were inductively analyzed and themes were identified. Results: It was found that amid experiences of fear, caregiver stress, grief, and exhaustion, HHCAs coped with resource, communication, and care challenges by relying on informal peer-managed communication systems with colleagues. Leveraging existing peer-support coping strategies, HHCAs negotiated caring for others while taking care of themselves alongside a care ecosystem under unprecedented strain. Conclusions: HHCAs are increasingly vital to front-line home health care amid global aging and a shift toward community-based services. Urgent organizational reform is needed to support their well-being, prevent stress, and avoid burnout. Research-informed sector-wide planning must ensure adequate resources to maintain high-quality home care in the face of rising demand and anticipated future health crises. Full article

Background: Family caregivers of patients with chronic diseases face high levels of burden, anxiety, and burnout, which may negatively affect both their well-being and patient outcomes. Low-cost, accessible telemedicine approaches may provide practical support in resource-limited settings. Methods: We conducted a prospective, parallel-group controlled study in Timisoara, Romania, between April 2024 and March 2025 and included 161 caregivers of older adults with chronic diseases, allocated 1:1 to receive either structured low-cost telemedicine support (weekly phone calls and SMS reminders; n = 82) or usual care (n = 79). Data were collected at baseline, three months, and six months through structured interviews. The primary outcome was caregiver burden measured by the Zarit Burden Interview (ZBI). Secondary outcomes included caregiver anxiety, burnout, satisfaction, and patient-related outcomes such as emergency room (ER) visits, hospital readmissions, and medication adherence. Analyses were performed using ANCOVA and logistic regression, adjusting for baseline values and relevant covariates. Results: At three months, caregivers in the intervention group had significantly lower burden scores compared to controls (adjusted mean difference −2.9; 95% CI −4.7 to −1.1; p = 0.002). Reductions in anxiety (−1.4; p = 0.02) and burnout (−1.6; p = 0.01) were also observed. These effects persisted at six months, though slightly attenuated. Patient outcomes favored the intervention: ER visits were lower at six months (27.50% vs. 41.02%; aOR 0.55, 95% CI 0.30–0.99; p = 0.047), while medication adherence and readmissions showed consistent but non-significant improvements. No adverse effects were reported. Conclusions: A simple, low-tech telemedicine program reduced caregiver burden, anxiety, and burnout and decreased ER visits. Improvements in medication adherence and readmissions were observed, but did not reach statistical significance. This pragmatic intervention can easily be integrated into primary care follow-up or community-based caregiver support programs, providing an affordable and low-cost technique to promote chronic disease management and caregiver well-being, especially in resource-limited health systems. Full article

Background: In response to the high prevalence of burnout in nursing, a hospital research team developed, studied, and implemented RISE (Resilience, Insight, Self-Compassion, Empowerment), a novel psychoeducational group program designed to reduce distress and promote well-being among professional caregivers, specifically nurses and nurse leaders. Pilot studies and randomized controlled trials showed positive results, and thus, the program was operationalized. Methods: This quality improvement/quality assurance (QI/QA) project involved scaling the program and gathering data to evaluate implementation and impact on well-being indicators. The intervention involves structured weekly (8–9 weeks) 90-min group sessions integrating mindfulness, cognitive-behavioral techniques, and acceptance and commitment therapy. Eight licensed mental health providers were trained and delivered the program. Implementation outcomes included adoption/stakeholder engagement, fidelity, provider satisfaction, participant engagement, and sustainability. Participant outcomes were measured through validated scales and participant feedback forms. The implementation process was examined at the participant, provider, and organizational levels to identify barriers and enabling factors. Results: The program was implemented in seven acute care hospitals. From January 2023 to December 2024, 160 participants completed the program. Effective implementation strategies included intensive training and supervision of qualified providers, multi-departmental collaborations, and rigorous fidelity monitoring. Quality improvement processes addressed challenges such as early attrition and administrative burden. Evaluation data from pre- and post-intervention surveys demonstrated statistically significant improvements in psychological outcomes, with high satisfaction reported by both participants and providers. Conclusion: The findings support the effective implementation of the program as part of a broader organizational strategy to address nurse burnout and workforce mental health. Lessons, implications, and future directions for healthcare leaders are discussed. Full article

Background/Objectives: Vicarious resilience is a positive psychological transformation in hospital nurses who witness the recovery and strength of patients. This study clarifies the concept using Walker and Avant’s method, identifying defining attributes, antecedents, and consequences to inform theory and practice. Methods: A systematic review of Korean and international databases included 21 studies. Through eight analytical steps, four defining attributes were identified: emotional growth, meaning-making, patient-centered engagement, and professional identity reinforcement. Results: Key antecedents include empathic exposure and reflective capacity. Consequences are enhanced resilience, reduced burnout, increased job satisfaction, and sustainable caregiving. Unlike compassion satisfaction, post-traumatic growth, or vicarious post-traumatic growth, vicarious resilience stems from relational experiences of patient recovery. The Vicarious Resilience Scale was reviewed, but a hospital nurse-specific measure is needed. Conclusions: This analysis offers a foundation for nursing education, organizational support, and interventions to foster emotional sustainability and professional growth in high-stress clinical settings. Full article

Background/Objectives: The child and adolescent mental health service (CAMHS) hand-over to adult mental health service (AMHS) remains an ongoing shortfall in eating disorder (ED) treatment, typically in tandem with diagnostic drift, heightened suicide risk, and carer burn-out. We created one 14-to-25 Transition—ED track within our own unit, where a single multidisciplinary team continuously follows each patient and family across the CAMHS–AMHS boundary (via weekly joint paediatric and adult clinician meeting) without changing the individual psychotherapist, family therapist, or dietitian at the age 18 transition. We investigated the manner in which patients and parents perceive this model. Methods: A survey of two naturalistic parent cohorts—CAMHS (n = 16) and Transition—Adult arm (n = 15)—also joined, alongside the original group of young adults who had entered the programme during its set-up phase (n = 9). Here, the 14–25 pathway denotes one unified route of care across adolescence and young adulthood; the Transition—Adult arm is its ≥ 18-years component. All index patients had a primary DSM-5-TR diagnosis of restricting-type anorexia nervosa. Participants completed the Client Satisfaction Questionnaire-8 (CSQ-8; range 8–32) and four bespoke Continuity-of-Care items (1–4 Likert). Results: Overall, the caregivers in both cohorts were pleased (median CSQ-8 = 28.5 [CAMHS] vs. 27.0 [Transition]; p = 0.75). Continuity items were universally well rated across cohorts. Cohort parents reported a median of two unchanged core clinicians (i.e., the individual psychotherapist, the family therapist, or the dietitian), which was nonsignificantly positively correlated with CSQ-8 scores (ρ = 0.22). Early-group patients mirrored caregiver impressions (mean CSQ-8 = 27.0 ± 3.9). Conclusions: It is feasible and highly acceptable to both caregivers and anorexia nervosa young adults to have the same key staff and family-centred sessions over the 14-to-25 age span. Constrained by single-site study and small sample size, these preliminary data provide a rationale for wider implementation and controlled follow-up studies. Full article

Background: Burnout syndrome (BS) is an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. Although there are underlying causes associated with personal attributes, it is generally linked to external factors within the work environment. The aim of the present study was to investigate the impact of lifestyle factors on BS and its dimensions, as well as on suicidal ideation among Spanish professionals dedicated to implant dentistry. Methods: A cross-sectional observational study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was distributed to members of the Spanish Society of Implants. The data were analysed using descriptive statistical methods. Results: A total of 305 participants (20.9%) responded to the questionnaire. Notably, 10.8% of the professionals reported experiencing suicidal thoughts, a factor significantly associated with the presence of BS. The lifestyle factors associated with BS included the following: not engaging in aerobic exercise for at least 30 min per day (p < 0.05), not having hobbies that facilitate mental disconnection from work (p < 0.001), not following a balanced diet (p < 0.0001), having an insufficient social life (p < 0.0001), and experiencing suicidal ideation (p < 0.01). Conclusions: The surveyed dentists generally reported having healthy lifestyle habits. Nevertheless, one in ten professionals acknowledged having experienced suicidal ideation at some point, highlighting a concerning association with BS. Full article

Background: Burnout syndrome (BS) is an occupational condition resulting from chronic stress, characterized by three dimensions, emotional exhaustion (EE), depersonalization (DE), and diminished personal accomplishment (PA), particularly prevalent in caregiving professions such as healthcare. The aim of this study is to analyse the prevalence of BS among Spanish dental implantology specialists, along with the impact of demographic, educational, and professional aspects. Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines and was open to respondents from May to December 2024. An electronic survey based on the Maslach Burnout Inventory—Human Services Survey (MBI–HSS) was sent to members of the Spanish Society of Implants. The data were analysed using descriptive analysis. Results: A total of 305 participants (20.9%) (31.5% females and 68.5% males) completed the questionnaire. The prevalence of BS was 4.3%; however, 61.0% of the dentists showed signs of suffering from the syndrome. The mean values of EE were “average” (20.3 ± 13.8) and of DE and EE “low” (5.1 ± 5.9, and 32.5 ± 14.5, respectively). The factors significantly associated with suffering from BS were being female and having more than 20 years of experience in dental implant treatments. Conclusions: It is advisable to conduct instructive and awareness-raising initiatives among dental professionals to promote an awareness of their mental health, ultimately aiming at preserving their physical and emotional well-being while delivering optimal care to their patients. Full article

Pediatric palliative care (PPC) is an evolving field that focuses on supporting children with life-limiting conditions, where the quality of care is vital. This study is a retrospective observational investigation that examines the experiences of caregivers to inform health and social service planning and enhance PPC quality. Methods: Data of pediatric patients aged 3 months to 18 years admitted to a PPC inpatient unit over two years were retrospectively reviewed. Sociodemographic characteristics of primary caregivers, including age, gender, number of siblings, education, income, occupation, and marital status, were recorded. Caregiver burden and burnout were assessed using the Zarit Burden Interview and the Maslach Burnout Inventory, respectively. Associations between caregiver characteristics and these measures were analyzed. Results: A total of 118 patients and caregivers were evaluated; 54.2% of patients were male. The most common diagnoses were neurological diseases (44.9%), followed by syndromic–genetic disorders (28.8%). About 34% of patients required more than three medical devices. Most caregivers were female (91.5%), mainly mothers and 53% had only primary education. No significant differences in care burden or burnout were found based on caregiver gender, marital status, or child’s diagnosis. However, the use of nasogastric tubes and multiple medical devices was associated with higher burnout. Lower income was significantly linked to higher care burden, while longer caregiving duration correlated with both increased burden and burnout. A moderate positive correlation was found between Zarit and Maslach scores. Conclusions: The complexity of PPC patients’ care increases caregiver burden and burnout. Expanding specialized PPC services is crucial to support caregivers and sustain home-based care. Full article

The cases that dog trainers and behavior consultants face are often traumatic and emotionally challenging, especially under pressure from distressed clients. This study investigated whether more years of professional experience and higher levels of dog aggression contribute to burnout and whether the overall emotional toll of caring moderates these relationships. Eighty-six professionals completed the Professional Quality of Life Measure, which evaluates the positive aspects of caregiving and negative outcomes such as burnout and secondary traumatic stress. The analysis revealed that neither extended work experience nor increased dog aggression significantly predicted higher burnout levels, and the anticipated moderating effect of emotional strain was not observed. The levels of burnout and secondary traumatic stress in this sample were similar to those reported in other animal-care and human healthcare settings, while the satisfaction derived from caregiving remained relatively high. These results suggest that factors beyond years of experience and dog aggression—such as workplace support and individual coping mechanisms—may be more crucial in influencing burnout among these professionals. This study highlights the need for an expanded investigation of other possible influences, such as workplace support and personal coping mechanisms. Identifying specific challenges that dog trainers face and implementing strategies to offset burnout will create a healthier and more sustainable work environment and improve the quality of life for humans and their canine companions. Full article

In Canada, 67% of unpaid caregivers are simultaneously balancing paid employment with unpaid care, equating to over 5.2 million Canadian Carer-Employees (CEs). This balancing act often incurs negative impacts on CEs’ health and well-being, including burnout, resulting in adverse effects on their labour force participation. To mitigate these social and economic impacts, McMaster University partnered with the Canadian Standards Association (CSA) to develop the CSA B701:17 (R2021) Carer-inclusive and accommodating organizations standard and accompanying handbook B701-18HB Helping worker-carers in your organization. Since publication in 2017, there has been minimal uptake of the Standard across Canadian workplaces, with just 1062 complimentary downloads total. To determine the level of uptake across workplaces in Canada, the present mixed-methods study used purposive sampling to collect survey (n = 71) and semi-structured interview data (n = 11). The survey data was analyzed for descriptive statistics and logistic regression modelling. The interview data were thematically analyzed for common CFWPs and barriers to Standard uptake. It was found that only 24% of workplaces have implemented the Standard into their workplace practices, with full implementation and current supports as strong predictors of formal uptake. Prominent themes around barriers to uptake and existing organizational policies highlight the critical importance of workplace culture in facilitating CFWPs. Full article

Background/Objectives: Understanding environmental experiences in residential dementia care is crucial for enhancing care practices, training, and policy. The environment’s role in dementia care is complex. Allied health and nursing professionals must consider environmental aspects concerning care for individuals with dementia. This study investigates how employed caregivers experience and perceive environmental influences in residential dementia care. Methods: In September 2024, we systematically searched PubMed, CINAHL, and PsycINFO for qualitative studies, adhering to SRQR guidelines. The CASP tool was used to assess study quality, ensuring rigor and reliability in selection. The meta-synthesis is registered with Prospero: CRD42024598962. A template analysis was conducted to structure emerging themes. Results: Fifteen studies met the inclusion criteria. Key themes included: 1. Working Environment: Informed understandings—capturing caregivers’ perceptions of organisational structures and support. 2. Lived Environment: Stability and Clarity—highlighting the impact of relational and social dynamics on caregiving; and 3. Physical and Built Environment: Impact on Overall Care Experience—looking at the role of space and design in facilitating effective dementia care. Following this, more subthemes emerged, resulting in the final template. Conclusions: The key gaps included understanding the existing strengths of practice, differences in job roles, funding, the role of Employed Caregivers, and Employed Caregivers’ personhood. Emphasising evidence-based practice and clearly defining job roles may improve decision-making and collaboration. It is essential to identify funding gaps and provide clear guidelines and training to ensure equitable care and maximise the contributions of Employed Caregivers working with nurses and allied health professionals. Recognising Employed Caregivers’ personhood could enhance job satisfaction and reduce burnout. Policies should address these gaps by providing training to clarify roles and enhance skills. A supportive, person-centred workplace may improve satisfaction and care outcomes. Future research should evaluate these aspects and continue to identify the best practices. Full article