Search Results (81)

Neuropsychiatric symptoms in dementia impact diagnosis and caregiver burden. Informal caregivers effectively identify cognitive changes and confirm the care receiver’s symptoms. This study aims to examine the association between neuropsychiatric symptoms in primary care users with probable dementia and caregiver burden and depression, as reported by informal caregivers, and describe the most frequent neuropsychiatric symptoms in this population. This cross-sectional study included 101 primary care users aged 65+ with mental health concerns identified by their General Practitioner and informal caregivers, excluding those in institutional care, without memory concerns and an informal caregiver, or without Neuropsychiatric Inventory Questionnaire (NPI-Q) data. The sample (79.4 ± 7.7 years) was 53.5% female, 33.7% had no formal education, and 60.4% presented probable dementia per Global Deterioration Scale. The NPI-Q total score and the distress dimension score were 10.1 (sd = 5.6) and 11.9 (sd = 9.1), respectively. The most reported symptoms were agitation/aggression (69.3%) and apathy/indifference (65.3%). We found a significant positive association between NPI-Q total and Distress scores and Caregiver Burden Scale, 0.296 (p = 0.023) and 0.417 (p < 0.001), and between NPI-Q total and Distress scores and AB Clinician Depression Screen, 0.227 (p = 0.023) and 0.416 (p < 0.001). Probable dementia was linked to more neuropsychiatric symptoms and greater caregiver burden and depression. Training for caregivers can improve the quality of care and, as a result, may reduce burnout and depression. Full article

Systemwide Social and Emotional Learning (SEL) promotes a host of academic and behavioral benefits for K-12 students. Yet, many schools face barriers to SEL implementation. Through a research–practice partnership, this study provides insights into facilitators of and challenges to systemwide SEL implementation. We collected 652 field notes of SEL in action across twelve schools in the Northeast and Western regions of the United States between December 2022 and May 2024. All field notes were analyzed with Dedoose using thematic inductive coding. Key facilitators of systemwide SEL include prioritization/support from leadership, professional development for educators, integration into students’ daily experiences, and engagement with parents/caregivers and the community. Key challenges to systemwide SEL involve leadership ambiguity, educator burnout, and student disengagement. Implications for optimizing SEL implementation in educational practice and policy are discussed. Full article

Burnout among long-term care workers is a public health concern, yet mixed-methods evidence from China is scarce. To examine multilevel correlates of burnout, a convergent mixed-methods study using a Social–Ecological Framework was conducted. In the quantitative strand, 494 workers were surveyed using two-stage cluster sampling, and probability-weighted multivariable linear regression examined factors associated with emotional exhaustion, depersonalization, and reduced personal accomplishment. In the qualitative strand, 15 participants completed semi-structured interviews; transcripts were managed in MAXQDA 2025 and analyzed thematically. Burnout was common (30.77% mild, 33.00% moderate, 17.00% severe). Quantitative findings showed that burnout dimensions were associated with gender, age, marital status, employment arrangement, institution type, training intensity, caregiver burden, and recognition of the long-term care insurance policy (p < 0.05). Qualitative findings highlighted cognitive adaptation, emotional reciprocity with older adults, organizational training and support, and policy recognition as potential buffering resources. These findings suggest that burnout is shaped by influences across multiple levels. Coordinated efforts may help alleviate burnout by strengthening training systems, reducing caregiving burden, enhancing recognition of long-term care policies, and elevating the societal value of care work. Future research should validate these potential courses of action through longitudinal or intervention studies. Full article

Background: Contemporary models of parental burnout conceptualize it as an interplay between parental demands and insufficient resources. However, research and current models remain sparse in their understanding of these demands and dynamics within the context of managing a child’s sleep wellness and related problems, which constitute a fundamental aspect in early parenting. The present work addresses this gap by examining this issue comprehensively. Methods: 2291 mother–child dyads were recruited from two sources: a random population sample (n = 1409) and a clinical sample (n = 882) of mothers seeking consultation for their child’s sleep issues (0–5 years old). Mothers completed an extensive panel of validated instruments and survey questions covering burnout and psychopathologies, sleep parameters, psychosocial, organizational, and demographic variables. Inferential analyses, regression modeling, cluster analysis, and mediation models were applied. Results: Two distinct profiles of parental burnout emerged: one associated with child sleep disturbances and the other with general parenting stress. The strongest-weighted risk factors pertained to maladaptive beliefs and perceptions (e.g., shame, “I am a bad parent”, “My child cries because I do not meet his needs”), as well as additive stressors such as interparental tension and daytime child behavioral problems. The strongest protective factors involved resources that reduced parental demands or facilitated recovery, including couple satisfaction, a consistent bedtime routine, greater capacity to take breaks (e.g., additional caregivers, father nighttime involvement, parental cohabitation, and child screen time). Conclusion: The identification of two distinct burnout profiles highlights the importance of incorporating, or placing more centrally, the management of young children’s insomnia in contemporary theoretical models of parental burnout. This research highlights the need for interventions on healthy self-beliefs and perceptions, effective daytime parenting strategies, positive couple dynamics, consistency in bedtime routines, and equitable distribution of caregiving responsibilities between parents to reduce the risk of parental burnout. Full article

Religiosity has been proposed as a meta-resource that may help parents endure chronic caregiving demands by anchoring parenting in meaning, values, and a sense of purpose—an idea compatible with Frankl’s view that suffering becomes more bearable when it is intelligible and oriented toward a “why.” In a cross-sectional sample of Polish parents (N = 339), we examined whether religiosity related to parental burnout through existential resources (presence and searching for meaning in life) and family-level resources (family functioning) while accounting for basic sociodemographic factors. The zero-order religiosity–burnout association was small and not statistically significant. Yet an indirect-only pattern emerged: higher religiosity was linked to lower parental burnout primarily through higher presence of meaning in life and better family functioning, including a small but reliable serial connection between these two resources. By contrast, global perceived support and generic searching for meaning did not add explanatory value once core resources were considered. In meaning-centred terms, religious faith may operate less as a direct “shield” against burnout and more as a pathway to sustaining everyday family practices and a stable sense of meaning that helps parents carry long-term demands. In other words, religiosity appears linked to lower burnout mainly indirectly via meaning and everyday family functioning, rather than through a sizable direct association. Full article

Background: Parenting is increasingly recognized as a highly demanding and stressful role that, in the absence of sufficient resources, may lead to parental burnout (PB). This risk may be particularly pronounced in the Russian context, where limited access to childcare for children under three and reduced extended family support coincide with strong social expectations of intensive parenting. Although PB and maternal depression frequently co-occur, it remains unclear whether PB exerts a unique influence on child development, especially during toddlerhood. The present study examined the association between PB and behavioral problems in children aged 1.5 to 4 years while controlling for maternal depression assessed both during the first year postpartum and concurrently with PB. Methods: Using a longitudinal design, maternal mental health was assessed within the first 12 months postpartum (Stage 1) and again at follow-up (Stage 2), on average 2.24 years later, in 419 Russian mother–child dyads. Mothers completed measures of postpartum depression (PPD) (Edinburgh Postnatal Depression Scale), current depressive symptoms (Beck Depression Inventory-II), and PB (Parental Burnout Inventory). Child emotional and behavioral problems were assessed at Stage 2 using the Russian version of the Child Behavior Checklist (CBCL/1½–5). Results: Mothers of children with borderline/clinically significant internalizing, externalizing, and total problems had significantly higher PB, PPD, and present maternal depressive symptoms, although the effect sizes were small. PB was strongly associated with all domains of child behavioral problems, also after correction for both postpartum and present depressive symptoms, as well as for other important covariates. Higher maternal PB symptoms further increased the odds of children having borderline/clinically significant internalizing and externalizing problems, although those effects were not independent of maternal depression. In turn, neither postpartum nor present maternal depressive symptoms were associated with any of the child behavioral problems domains. Conclusions: PB represents a distinct and clinically relevant risk factor for emotional and behavioral problems in toddlers, beyond the effects of maternal postpartum or present depression, in a context characterized by high caregiving demands and limited institutional support. These findings highlight an urgent need for programs aimed at identifying and supporting families in which parents experience high levels of exhaustion, regardless of whether they meet the criteria for other diagnosable mental health disorders. Addressing PB during toddlerhood may be critical for protecting both parental well-being and early child development. Full article

Parentification is the process in which children assume caregiving roles typically designated for parents. Prior research suggests that adults with a history of childhood parentification tend to find themselves in relationships where they continue their caregiving roles, leading to emotional exhaustion and couple burnout. This study examines the associations among childhood parentification, partner parentification, and couple burnout, and investigates the mediating role of partner parentification in the relationship between childhood parentification and couple burnout. A multi-method research design, with a quantitative sample comprising 283 married individuals aged 18–65 who had been married for at least 6 months, was used. The quantitative measures were the Partner Parentification scale, Parentified Child Scale-Adult Version (PCS-A), and Couple Burnout Measure-Short Form (CBMS). Within the scope of the quantitative study, the path analyses revealed that partner parentification partially mediated the association between childhood parentification and couple burnout. Qualitative data were collected to assess partner parentification experiences, and the deductive content analysis results revealed aspects similar to those of childhood parentification. The findings suggest that childhood parentification shares similar aspects with partner parentification, and individuals who were parentified by their parents were eager to be parentified by their spouses, experiencing couple burnout in their relationships. Full article

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