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To examine the association between caregiving context and the health and well-being of community-dwelling people with dementia (functional ability, physical function, depression, quality of life and health-related quality of life) and their informal carers (health-related quality of life) at the pre-rehabilitation stage and the potential mediating role of caregiving context variables.
Cross-sectional study.
Secondary analysis of baseline data from a randomised controlled trial of 130 dementia care dyads—the Interdisciplinary Home-based Reablement Programme (2018–2022). Bivariate analyses were applied to identify key caregiving context variables—co-residence, sole carer status, additional caring responsibilities, client-carer relationship and subjective carer burden (carer burden hereafter)—associated with health outcomes. Subsequently, multivariable linear regression models were developed. To examine carer burden, two models were run for each outcome: one with caregiving context variables and covariates, and the other adding carer burden. The mediating effects of the identified caregiving context variable were examined using post hoc mediation analysis.
Spouse/partner carer relationship was significantly associated with better client well-being, including lower depressive symptoms and higher quality of life scores compared to adult child and other relationships. Higher carer burden was strongly associated with lower functional ability, more depressive symptoms, lower quality of life for clients and lower health-related quality of life for both clients and carers. Including carer burden in regression models explained the greatest variance across most models. Carer burden fully mediated the association between additional caring responsibilities and client functional ability, and partially mediated the association between other carers and client depression.
Carer burden needs to be carefully considered in supporting the health and well-being of dementia carer dyads.
Addressing carer burden and tailoring support to carers are essential for optimising health impacts for dementia carer dyads.
STROBE checklist.
None.
ClinicalTrials.gov identifier: ACTRN12618000600246
To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.
Position paper.
This paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.
This position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID-19 and incoming reforms. It calls for nurse-led research and innovation to deliver tools to address these challenges.
The paper proposes an appropriate holistic, evidence-based nursing framework to optimise the quality and safety of residential aged care in Australia.
This study did not include patient or public involvement in its design, conduct, or reporting.
To cross-culturally adapt a framework for person-centred leadership in residential care for older people in Sweden.
This study has an exploratory and descriptive design.
The translation procedure followed a cyclic process of translation into Swedish and back-translation into English by two independent bilingual linguists. An evaluation of conceptual and semantic equivalence and comprehensiveness between the original English version and the translated Swedish version was performed by an expert committee. The translated version of the framework was validated by leaders (n = 34) in residential care, who assessed its relevance through a web form. The adaptation of the framework followed recommended guidelines for cross-cultural adaptation.
The translation procedure resulted in two minor changes related to the wording in two descriptors. The results of the validation procedure showed that the framework is relevant for leaders in Swedish residential care for older people.
The cross-culturally adapted framework is useful and suitable for leaders in Swedish residential care for older people. The framework clarifies the leader's role and identifies leadership attributes and requirements for person-centred leadership in residential care, thereby providing support to leaders by framing person-centred leadership.
The framework can be used as a guide for leadership training and/or development initiatives in residential care. It can be further extended to nursing curriculums, leadership development programs, and organisational performance and development processes. It may also provide a foundation for policy and guidelines by establishing the activities required for leaders to promote person-centredness in the care of older people.
This study followed the STROBE checklist for cross-sectional studies.
There was no patient or public contribution.
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