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Lisa P Gwyther

Publications and source records attributed to Lisa P Gwyther.

6 recordsLinked to original sources

Associations among perceptions of social support, negative affect, and quality of sleep in caregivers and noncaregivers.

The authors used structural equation modeling to examine associations among perceptions of negative affect, social support, and quality of sleep in a sample of caregivers (n = 175) and noncaregiver control participants (n = 169). The authors hypothesized that caregiver status would be related to sleep quality directly and also indirectly by way of negative affect and social support. This hypothesis was partially supported in that caregiving was found to be indirectly related to sleep quality. However, after accounting for the indirect effects of negative affect and social support, the direct effect of caregiving on sleep quality was no longer statistically significant. The structural model accounted for approximately 43% of the variance in sleep quality. The present findings may be useful in the development of successful sleep interventions for caregivers.

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Promoting a good death for persons with dementia in nursing facilities: family caregivers' perspectives.

The experience of dying from Alzheimer's disease (AD) in a nursing home setting is a poorly understood phenomenon. Fifty-seven family member caregivers of persons with Alzheimer's disease, who had died as a resident in a national nursing home chain, participated in a structured telephone interview. Despite the belief that their loved one had died with dignity, 16 out of 57 (28%) family member caregivers believed that their loved one had not experienced a good death. This article reviews the definition of a good death and the six themes of a good death found in the literature: pain and symptom management; clear decision making; preparation for death; completion; contributing to others; and affirmation of the whole person. Five standards for evaluating the quality of an anticipated death are discussed in relation to the experiences of the persons with AD. Finally, recommendations for how nurse administrators and other members of the healthcare team can promote a positive death experience for a person with AD are proposed.

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A multinational review of recent trends and reports in dementia caregiver burden.

This systematic review of the literature focuses on the influence of ethnic, cultural, and geographic factors on the caregivers of patients with dementia. In particular, we explore the impact of cultural expectations on five important questions: 1) Do the characteristics of dementia affect caregiver burden? 2) Do characteristics of the caregiver independently predict burden? 3) Does the caregiver affect patient outcomes? 4) Does support or intervention for caregiver result in reduced caregiver burden or improved patient outcomes? 5) Finally, do patient interventions result in reduced caregiver burden or improved patient outcomes? Our findings suggest that noncognitive, behavioral disturbances of patients with dementia result in increased caregiver burden and that female caregivers bear a particularly heavy burden across cultures, particularly in Asian societies. Caregiver burden influences time to medical presentation of patients with dementia, patient condition at presentation, and patient institutionalization. Moreover, interventions designed to reduce caregiver burden have been largely, although not universally, unsuccessful. Pharmacological treatments for symptoms of dementia were found to be beneficial in reducing caregiver burden. The consistency of findings across studies, geographic regions, cultural differences, and heathcare delivery systems is striking. Yet, there are critical differences in cultural expectations and social resources. Future interventions to reduce caregiver burden must consider these differences, identify patients and caregivers at greatest risk, and develop targeted programs that combine aspects of a number of interventional strategies.

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