Search Results (1,079)

Contemporary Chinese society has undergone enormous socio-economic transformations over the past four decades. The Confucian principle of so-called filial piety (xiao) has shaped Chinese culture for centuries, laying the foundation for family and social life. However, the current Chinese reality, with widespread consumerism and economization of thinking, requires young Chinese people to redefine their role in relation to their aging parents. The process of individualization in a strongly group-oriented society undergoing intense transformation, coupled with the strong cultural pressure to implement the Confucian xiao principle, provides material for interesting research questions. This paper studies caregivers’ coping strategies in the context of the principle of filial piety and the form of its practice during the pandemic and lockdown. It aims to capture the impact of the unique experience of isolation, exacerbated by the fear and uncertainty about the fate and health of parents. At the methodological level, it uses quantitative and qualitative analysis, adapting well-known scales and customized queries to capture the social challenges of the COVID-19 pandemic. Full article

Background: Access to water, sanitation, and hygiene (WASH) services is internationally recognized as a fundamental human right and an essential determinant of health. Yet, many healthcare facilities in sub-Saharan Africa face persistent WASH deficits, undermining safe and effective care delivery. Aim: To explore how water (in)accessibility influences patient healthcare experiences and patient–provider relationships in Yendi Hospital, a major referral facility in northern Ghana. Methods: Using a qualitative design, we gathered data from patients (n = 21), caregivers (n = 11), and nurses (n = 11) through in-depth interviews, participant observation, and a focus group to document their lived experiences and perceptions. We transcribed and inductively coded the data for thematic analysis. Results: Our key findings reveal that water inaccessibility is not solely an infrastructural issue but also a pervasive challenge with profound implications for care delivery. Patients and caregivers often leave the hospital to bathe at home, resulting in missed ward rounds, delayed reviews, and/or refusal of admission. Nurses described how water inaccessibility disrupted clinical routines and strained relationships with patients and caregivers. These dynamics eroded trust, rapport, and professional morale, while exacerbating inequities in healthcare access and outcomes. Conclusions: This study underscores that addressing water challenges in the hospital is imperative not only for infection control but also for fostering equity, patient rights, and institutional resilience. We argue that policy interventions to strengthen WASH systems are urgently required to advance progress toward Sustainable Development Goal 6. Full article

Sepsis and septic shock affect nearly 49 million people worldwide each year. Although advances in early recognition and evidence-based management have improved survival, many patients experience long-term cognitive, physical, and psychological impairments collectively known as post-intensive care syndrome (PICS). These sequelae often extend to families and caregivers (PICS-F), resulting in lasting declines in quality of life. Recovery from sepsis represents a continuum that begins during intensive care and extends into survivorship. Decisions regarding analgesia, sedation, delirium prevention, mobilization, and family engagement shape this recovery trajectory. The ABCDEF bundle provides an evidence-based framework to mitigate these long-term effects through structured approaches to pain control, paired awakening and breathing trials, targeted sedation, early mobility, and family involvement. This narrative review synthesizes current evidence on PICS in sepsis and septic shock and examines how implementation of the ABCDEF bundle across the continuum of care can reduce the incidence and severity of post-ICU impairments. Reframing sepsis survivorship as an ongoing process rather than an endpoint underscores the need for critical care practices that promote not only survival but also restoration of function, cognition, and quality of life. Full article

Introduction: Although childhood fever is a common and typically self-limiting clinical presentation, it imposes a substantial emotional and psychological burden on caregivers, especially mothers, primarily due to enduring practices and beliefs that diverge from contemporary evidence-based medical guidelines. Objective: The aim was to investigate how families perceive pediatric fever, identify the factors influencing their caregiving decisions, and examine their experiences across various healthcare settings. Methodology: A qualitative study employing an ethnomethodological approach was conducted at a tertiary care hospital in Spain. The study included ten caregivers (nine mothers and one father) of children presenting with fever. Data were collected through in-depth interviews and field diary observations. Analysis was performed using a combination of inductive and deductive methods, supported by the Atlas.ti 25.0.1 version software. Results: Mothers perceive childhood fever as a disruptive event necessitating rapid decision-making, shaped by emotional responses, prior experiences, culturally transmitted knowledge, and social context. Common caregiving practices included routine administration of antipyretics, application of physical remedies, and early utilization of emergency healthcare services. The caregiver–healthcare professional relationship was characterized by ambivalence, highlighting the need for enhanced health education and greater emotional support for caregivers. Conclusions: Childhood fever represents both a clinical condition and a sociocultural phenomenon. Gaining insight into family practices and beliefs enables the development of more effective, empathetic educational interventions, which can enhance caregiving practices and mitigate parental anxiety. Reporting method: Standards for Reporting Qualitative Research (SRQR) guidelines. Full article

Stroke survivors frequently experience long-term disability, post-stroke fatigue, frailty, sarcopenia, falls, and psychosocial distress, which together drive poorer functional recovery, rehospitalization, institutionalization, and caregiver burden. This narrative review synthesizes contemporary evidence on the prevalence, mechanisms, and clinical impact of post-stroke fatigue, frailty, sarcopenia, and falls and examines their links with palliative care needs, healthcare costs, and emerging telehealth models. A PubMed and Google Scholar search up to October 2025 identified studies on stroke and fatigue, frailty, sarcopenia, falls, palliative care, and telehealth, with an emphasis on clinical studies, trials, systematic reviews, and guidelines in adults. Frailty and sarcopenia are highly prevalent after stroke and predict mortality, poor functional outcome, reduced rehabilitation response, and higher care needs. Post-stroke fatigue is common, multifactorial, and associated with worse quality of life and reduced return-to-work rates. Falls are frequent and arise from the combined effects of focal neurological deficits and systemic frailty/sarcopenia. Despite substantial symptom burden, palliative care is often introduced late and inconsistently. We summarize brief, validated screening tools, such as the Clinical Frailty Scale, SARC-F plus grip strength, Malnutrition Universal Screening Tool, Fatigue Severity Scale/Neurological Fatigue Index for Stroke, Short Physical Performance Battery, and fall-risk instruments. We propose pragmatic timepoints and referral thresholds for their use in stroke services. Multicomponent interventions that integrate exercise, nutritional optimization, psychosocial support, and structured fall prevention can reduce frailty, sarcopenia, and falls and improve function and mood. Telemedicine and telerehabilitation may enhance access and continuity but risk widening digital inequities. Earlier, structured palliative approaches aligned with patient goals are needed across the frailty–sarcopenia–stroke continuum. Implementing integrated screening–intervention pathways and hybrid telehealth models could improve long-term outcomes for stroke survivors and their caregivers while supporting more efficient use of healthcare resources. Full article

Dogs are often viewed as family members, and many owners describe them as “fur babies.” However, little is known about how women with and without children perceive and practice caregiving toward their dogs, and how these experiences relate to parenting. This qualitative study explored the meanings of dog and child caregiving among 28 dog-owning women (13 mothers and 15 childless) through semi-structured interviews. All participants had lived with their dog for at least one year. Thematic analysis identified five main themes: (1) emotional meanings and motivations of caregiving, (2) practical caregiving and daily routines, (3) responsibility and dependency, (4) social relationships and support, and (5) life course perspectives. Both mothers and non-mothers described their dogs as sources of joy, companionship, and unconditional love. Women without children often saw their dogs as child substitutes, while mothers stressed the greater responsibility and permanence of raising children. Dog ownership and parenting influenced social life and work differently: dogs often increased social interaction and offered flexibility, whereas children introduced stricter routines and reduced spontaneity. Overall, dogs fulfilled important emotional and caregiving needs, particularly among women without children, but did not replace the unique social and moral responsibilities of parenting. Full article

This study uses the National Survey of Children’s Health to examine the nationwide prevalence and severity of US adolescent mental health issues in the 12–17 age group between the years 2022 and 2023 in relation to parental mental health and exposure to adverse childhood experiences (ACEs). We used the NSCH data collected for 12–17-year-old adolescents. Descriptive statistics were generated for the selected sample and binary logistics regressions were conducted to examine influential factors for the presence and severity of adolescent depression and anxiety for the selected year. Adolescents aged 12–17 who experienced neighborhood violence had higher odds of being diagnosed with anxiety (OR = 1.369, p = 0.009) and depression (OR = 1.508, p = 0.004). Those living with someone who was mentally ill, suicidal, or severely depressed showed increased odds of anxiety (OR = 1.642, p < 0.001) and depression (OR = 1.587, p < 0.001). Adolescents judged unfairly due to a health condition or disability had markedly higher odds of anxiety (OR = 3.056, p < 0.001) and depression (OR = 1.835, p < 0.001), including severe forms (severe anxiety OR = 2.569; severe depression OR = 2.238; both p < 0.001). Poorer parental emotional health was consistently associated with higher adolescent anxiety and depression, with “fair” parental emotional health showing the strongest association for depression (OR = 7.320, p < 0.001). These findings demonstrate the need for better tailored mental health efforts towards both adolescents and their caregivers highlighting the harm of long-term environmental and familial stressors, and the gaps in community approaches in this population. Full article

Background/Objectives: Family caregivers of individuals with bipolar disorder (BD) experience substantial burden, yet scalable caregiver-focused supports are scarce. This pilot study tested a nurse-led telephone program to evaluate feasibility and acceptability and to explore perceived impacts on caregiver burden, coping, and well-being. Methods: A descriptive pilot case study was conducted in an adult psychiatric inpatient unit in Portugal. Six informal caregivers of inpatients with BD completed a structured six-call protocol over approximately 6–8 weeks. Results: Overall, 6 caregivers completed the full cycle, totaling 36 sessions (6 assessment, 18 psychoeducational, 6 psychosocial, and 6 evaluation sessions). Thematic analysis identified four recurrent themes: (1) embracing the caregiver role—recognizing personal needs and legitimizing help-seeking; (2) patience and understanding—adopting emotion-regulation strategies; (3) self-reflection on personal strengths—increased self-efficacy and acknowledgment of persistence, empathy, and resilience; and (4) fostering hope and resilience—expressing future-oriented goals consolidated in a personalized “hope kit.” Conclusions: A brief, protocolized, nurse-delivered telephone program for caregivers of inpatients with BD was both feasible and acceptable, producing meaningful qualitative benefits consistent with the aims of psychoeducation (knowledge acquisition, coping, and emotional regulation). Findings support the use of telephone support as a pragmatic complement to standard BD care and justify larger controlled studies to quantify effects on caregiver burden, mood, and resilience, and to compare telephone, in-person, and blended delivery models. Full article

Background: Compassion fatigue (CF) is a state of emotional and physical exhaustion in the caregiving relationship, which can negatively impact patient safety and quality of care. Maternity care professionals are particularly vulnerable to CF due to their continuous empathetic engagement with patients in an unpredictable, high-stress work environment. Despite its significance, research on CF in maternity care is limited. The aim of this study is to explore experiences of CF among maternity care professionals. Methods: A thematic analysis of semi-structured in-depth interviews was conducted. The sample consisted of seven midwives and three gynecologists from different hospitals and outpatient care in Flanders (Belgium). Results: Experiences, risk factors and protective factors were identified as three organizing themes and further refined into 12 subthemes. Participants showed limited familiarity with the term CF but recognized its symptoms, including emotional exhaustion, reduced empathy, and a diminished ability to provide care, ‘as one normally would’. Key risk factors included high workload, emotional strain from ‘energy-consuming’ patients, fear of errors, and administrative burden. A supportive team environment, compassion satisfaction (CS), job autonomy and personal coping skills were identified as protective factors. Participants emphasized the need to recognize and address signals of CF. Conclusions: CF among maternity care professionals is underrecognized but appears to impact both caregiver well-being and patient care quality. Interventions should target awareness, team communication, psychological safety, and organizational context. A multilevel approach—combining individual, team, and systemic strategies—is needed to sustainably mitigate CF in maternity care. Full article

This study used Q methodology to explore and categorise caregivers’ subjective perceptions of artificial intelligence (AI)-powered ‘virtual human’ (AVH) devices in caring for older adults. We derived 123 initial statements from literature and focus groups and narrowed them to 34 statements as the final Q sample. Seventeen caregivers, nurses, and social workers completed the Q-sorting procedure. Using principal component analysis and Varimax rotation in Ken-Q, we identified three perception types: Active Acceptors, who emphasise the devices’ practical utility in patient communication; Improvement Seekers, who conditionally accept the technology while seeking greater accuracy and effectiveness; and Emotional Support Seekers, who view the device as a tool for emotional relief and psychological support. These findings suggest that technology acceptance in caregiving extends beyond functional utility. It also involves trust, affective experience, and interpersonal interaction. This study integrates multiple frameworks, including the Technology Acceptance Model (TAM), the Unified Theory of Acceptance and Use of Technology (UTAUT), Science and Technology Studies (STS), and Human–Machine Communication (HMC) theory, to provide a multifaceted understanding of caregivers’ acceptance of AI technology. The results offer valuable implications for designing user-centred AI care devices and enhanced emotional and communicative functions. Full article

Background: This cross-sectional observational study examined the relationship between caregivers’ adverse childhood experiences (ACEs), their perceived COVID-19-related burden, child psychopathology, and changes in family relationships during the pandemic. Methods: The final sample included 285 children (M = 10.19, SD = 3.36) from clinical settings and their caregivers. Caregivers reported their own ACEs and their children’s psychopathology. Perceived caregiver COVID-19 burden and changes in family relationships were also assessed. Correlational analyses, regressions, and mediation models were conducted to test direct and indirect associations. Results: Caregivers reported an average of 1.63 ACEs, with 18.4% reporting four or more. Children of caregivers who reported four or more ACEs exhibited significantly elevated psychopathology scores. However, caregiver ACEs did not directly predict the perceived COVID-19 burden. A mediation analysis revealed that child psychopathology mediated the association between caregiver ACEs and caregiver COVID-19 burden. Unexpectedly, higher caregiver ACEs were associated with less negative perceived changes in family relationships, particularly in 2023, indicating heterogeneous family adjustment trajectories. Conclusions: These findings highlight that child psychopathology is a key mechanism in the intergenerational transmission of caregiver burden linked to childhood adversity. They also suggest that support systems, resilience, or differing expectations among high-ACE caregivers may help buffer changes in family relationship. Early identification and trauma-informed, family-centered interventions beyond acute crisis are essential. However, limitations include the reliance on caregiver self-report and cross-sectional design. Further, longitudinal, multi-informant research is needed to clarify these dynamics and inform targeted support strategies. Full article

Background: Pediatric oncological diagnoses and treatments pose complex biopsychosocial challenges for both patients and their families. These experiences can significantly disrupt daily life, evoke intense emotional responses, and raise concerns about the future, often leading to long-term psychological implications. Objective: This study aimed to assess the emotional functioning of children undergoing cancer treatment and to explore the lasting psychological effects reported by young adult survivors of pediatric cancer. Methods: A mixed-methods approach was employed. In total, 52 minors and their caregivers were recruited from two pediatric oncology units in Italy (Turin and Bari), while 18 young adults diagnosed during childhood were recruited from clinical and community settings in Ancona and Bari. Standardized instruments were used to evaluate emotional symptoms and broader psychological functioning in the pediatric sample, while self-report measures assessed psychological well-being and quality of life in the young adult group. To complement these data, semi-structured interviews were conducted with the young adult survivors to investigate the long-term psychosocial and psychological impacts of pediatric cancer. Results: The quantitative results indicate generally low levels of psychological distress in both groups. However, the qualitative findings reveal the complexity of post-cancer identity, highlighting experiences of resilience, emotional ambivalence, and redefinition of self. Conclusions: These results underscore the importance of addressing the psychological well-being of pediatric oncology patients and young adult survivors beyond the medical treatment phase, with a focus on long-term psychosocial support and individualized care. Full article

Background/Objectives: Schizophrenia Spectrum Disorder (SSD) represents a major challenge for healthcare systems due to its chronic nature, comorbid conditions, and high socioeconomic impact. Ensuring high-quality care for patients with SSD requires well-defined quality criteria based on consensus from healthcare professionals, patients, and caregivers. This study aims to identify and prioritize quality criteria for SSD care. Methods: A qualitative research approach was applied, including incorporating two focus groups—one with patients and caregivers (n = 7) and another with healthcare professionals (n = 8)—alongside the Delphi technique. The Delphi panel included 32 participants from psychiatry, primary care, mental health nursing, social work, and patient associations. The first round had an 88.9% response rate, while the second round achieved full participation (100%). The Delphi process was conducted and reported according to recommended guidelines for consensus methods (ACCORD checklist), specifying panel composition, rounds, predefined consensus thresholds, and controlled feedback between rounds. Results: A total of 26 quality criteria were ultimately selected, categorized into 16 identified barriers to effective care. Key priorities included early diagnosis protocols, coordinated multidisciplinary care, and improved access to specialized mental health services. Conclusions: The findings underscore the necessity of integrating patient experience into healthcare evaluation and highlight the potential for implementing a certification system to standardize SSD care across healthcare settings. Full article

(1) Background: Medication shortages have become increasingly common in the UK. However, there is limited evidence regarding the experiences of people with epilepsy and their caregivers during these shortages. The aim of this study is to explore the extent and impact of ASM shortages on people with epilepsy and their caregivers across the UK. (2) Methods: A cross-sectional online survey was distributed between January and April, 2024 by epilepsy charities. Participants included people with epilepsy and caregivers. The survey collected demographic information, types of ASM respondents were prescribed, experiences of shortages, and the impact of shortages. Data were analysed descriptively, and subgroup analyses were conducted by medication type. (3) Results: A total of 1549 responded, of whom 1312 were people with epilepsy and their carers who were included in the analysis with a mean age of 43 years. A total of 941 respondents (71.7%) reported difficulty obtaining their prescribed ASM in the past year. Shortages were most frequently reported for sodium valproate (60.8%), lamotrigine (65.2%), carbamazepine (92.6%), clobazam (82.6%), topiramate (81.5%), zonisamide (74.0%), levetiracetam (62.8%), lacosamide (71.0%), and brivaracetam (70.5%). A total of 529 (40.4%) of the participants reported that stress and/or anxiety caused by medication shortages was associated with recurrent seizures. We did not ask whether patients missed medications because of these difficulties. (4) Conclusions: ASM shortages are a widespread issue for people with epilepsy in the UK, leading to treatment disruptions and psychological distress. Addressing supply change limitations and identifying effective approaches to preventing the substitution of ASMs brands by clinicians may potentially reduce this problem. Full article

Background/Objectives: With global population aging, long-term care (LTC) facilities play an essential role in supporting older adults. However, residents are vulnerable to dignity loss in these institutional settings. Understanding dignity from the perspectives of residents, staff, and relatives is critical for informing person-centered care and policy. This review aimed to synthesize qualitative evidence on dignity in LTC facilities across multiple stakeholders. Methods: Following the PRISMA guidelines, we systematically searched six databases (PubMed, Scopus, Web of Science, Wan Fang, VIP, and CNKI) for qualitative studies published in 2010–2023. Eligible studies explored experiences of dignity among older LTC residents, staff, or relatives. Methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Data were analysed through thematic synthesis, and findings were compared across stakeholder groups. Results: A total of 1948 records were identified, of which 27 qualitative studies met the inclusion criteria. Two themes emerged from residents’ perspectives: institutionalization and resilience in preserving dignity. From staff perspectives, three themes were identified: understaffing and workload pressures, general approaches to dignity care, and person-centered care. Relatives’ accounts highlighted two themes: uneasiness regarding indignity and ethical expectations in a caring culture. Integrating these perspectives, we propose a triangular model in which residents, staff, and relatives collaboratively sustain dignity. Conclusions: Older adults’ dignity in LTC is shaped by complex interactions among institutional conditions, caregiving practices, and family involvement. Enhancing dignity requires adequate staffing, structural support for person-centered care, and greater involvement of relatives in decision-making. The proposed triangular model offers a framework for guiding interventions, staff training, and policy reforms aimed at safeguarding dignity in LTC facilities. Full article