Caregivers’ Environmental Barriers in Caregiving in Adults with a Terminal Illness

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Abstract

Caring for a patient at the end of their life can be highly demanding and becomes a challenge for caregivers. The participants were recruited using a convenience sampling of ten caregivers who provided the most care to an adult with a terminal illness. All interviews were recorded, transcribed verbatim and analyzed using the six steps of Interpretative Phenomenological Analysis (IPA). The findings showed that the environmental barriers caregivers had recognized were transportation, insufficient material resources, and remote home facilities. By acknowledging these barriers, healthcare professionals can design and implement therapeutic environments that are clinically relevant toward those most in need.Keywords: Environmental barriers; terminal illness; adult; caregivereISSN 2398-4295 © 2017 The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.

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Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis.

Silvia Sörensen, Martin Pinquart (2005)

We investigated ethnic differences in caregiver background variables, objective stressors, filial obligations beliefs, psychological and social resources, coping processes, and psychological and physical health. We used a meta-analysis to integrate the results of 116 empirical studies. Ethnic minority caregivers had a lower socioeconomic status, were younger, were less likely to be a spouse, and more likely to receive informal support. They provided more care than White caregivers and had stronger filial obligations beliefs than White caregivers. Asian-American caregivers, but not African-American and Hispanic caregivers, used less formal support than non-Hispanic White caregivers. Whereas African-American caregivers had lower levels of caregiver burden and depression than White caregivers, we found that Hispanic and Asian-American caregivers were more depressed than their White non-Hispanic peers. However, all groups of ethnic minority caregivers reported worse physical health than Whites. Observed ethnic differences in burden and depression were influenced by study characteristics, such as the type of illness of the care recipient and the representativeness of the sample. The results suggest that more specific theories are needed to explain differential effects of ethnic minority groups of caregivers. Intervention needs vary, in part, between ethnic groups of caregivers.

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Place, not race: disparities dissipate in southwest Baltimore when blacks and whites live under similar conditions.

Thomas LaVeist, Keshia Pollack, Roland Thorpe … (2011)

Much of the current health disparities literature fails to account for the fact that the nation is largely segregated, leaving racial groups exposed to different health risks and with variable access to health services based on where they live. We sought to determine if racial health disparities typically reported in national studies remain the same when black and white Americans live in integrated settings. Focusing on a racially integrated, low-income neighborhood of Southwest Baltimore, Maryland, we found that nationally reported disparities in hypertension, diabetes, obesity among women, and use of health services either vanished or substantially narrowed. The sole exception was smoking: We found that white residents were more likely than black residents to smoke, underscoring the higher rates of ill health in whites in the Baltimore sample than seen in national data. As a result, we concluded that racial differences in social environments explain a meaningful portion of disparities typically found in national data. We further concluded that when social factors are equalized, racial disparities are minimized. Policies aimed solely at health behavior change, biological differences among racial groups, or increased access to health care are limited in their ability to close racial disparities in health. Such policies must address the differing resources of neighborhoods and must aim to improve the underlying conditions of health for all.

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Caregiving in a patient's place of residence: turnover of direct care workers in home care and hospice agencies.

Janette S Dill, John Cagle (2010)

High turnover and staff shortages among home care and hospice workers may compromise the quality and availability of in-home care. This study explores turnover rates of direct care workers for home care and hospice agencies. OLS (ordinary least square) regression models are run using organizational data from 93 home care agencies and 29 hospice agencies in North Carolina. Home care agencies have higher total turnover rates than hospice agencies, but profit status may be an important covariate. Higher unemployment rates are associated with lower voluntary turnover. Agencies that do not offer health benefits experience higher involuntary turnover. Differences in turnover between hospice and home health agencies suggest that organizational characteristics of hospice care contribute to lower turnover rates. However, the variation in turnover rates is not fully explained by the proposed multivariate models. Future research should explore individual and structural-level variables that affect voluntary and involuntary turnover in these settings.

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Author and article information

Journal

Title: Asian Journal of Behavioural Studies

Abbreviated Title: AjBeS

Publisher: e-IPH Ltd.

ISSN (Electronic): 2398-4295

Publication date Created: October 23 2017

Publication date (Electronic): October 23 2017

Volume: 2

Issue: 8

Page: 23

Article

DOI: 10.21834/ajbes.v2i8.51

SO-VID: 81525eda-438c-40e9-b0a1-bd24e2ae87e5

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This work is licensed under a Creative Commons Attribution 4.0 Unported License. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-nd/4.0/

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ScienceOpen disciplines: Psychology,Urban design & Planning,Urban studies,General behavioral science,Cultural studies

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ScienceOpen disciplines: Psychology, Urban design & Planning, Urban studies, General behavioral science, Cultural studies

Caregivers’ Environmental Barriers in Caregiving in Adults with a Terminal Illness

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Asian Journal of Behavioural Studies (AjBeS)

Most cited references 13

Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis.

Place, not race: disparities dissipate in southwest Baltimore when blacks and whites live under similar conditions.

Caregiving in a patient's place of residence: turnover of direct care workers in home care and hospice agencies.

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