Identification and Description of Changing Patterns of Patient Cognition, Patient Mobility, and Caregiver Depression in the Caregiver-Patient Relationship Over Time

2.50
Hdl Handle:
http://hdl.handle.net/10755/156822
Type:
Presentation
Title:
Identification and Description of Changing Patterns of Patient Cognition, Patient Mobility, and Caregiver Depression in the Caregiver-Patient Relationship Over Time
Abstract:
Identification and Description of Changing Patterns of Patient Cognition, Patient Mobility, and Caregiver Depression in the Caregiver-Patient Relationship Over Time
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Offner, Judith, DNS/DNSc/DSN
P.I. Institution Name:BHS, Camden County Health Services Center
Title:Clinical Nursing Specialist
Objective: The purpose of this study was to describe and identify the changing patterns of patient cognition, patient mobility and caregiver depression within the context of Offner's theory of waxing and waning caregiver-patient relationships. Design: This descriptive quantitative study represented a secondary analysis from a study of caregiver responses to managing elderly patients at home. Population, Sample, Setting, Years: Of the 736 caregivers and patients in the original data set, 50 patient care-giver dyads had complete data and were used in the present study. The original sample was obtained from consenting caregivers and patients who were recruited at several urban Michigan hospitals. Patients in the current study were male (54%) or female (46%), married (64%), and widowed (30%). Many (74%) patients and caregivers cohabited. The average age was 78.5 years and ranged from 60-92 years. The majority of caregivers in the current study were female (86%), white (85%), spouses (62%) and daughters (26%). Most caregivers were married (84%) and their average age was 62 with the range from 27 to 92 years. Variables Studied: Patient cognition, patient mobility, and caregiver depression were selected to serve as quantifiable variables to illustrate changing patterns within the caregiver-patient dyad over time. The Patient Cognition Assessment Instrument, Patient Mobility Assessment Instrument, and Center for Epidemiological Studies' Depression Scale measured the variables. Cronbach alpha levels ranged from .66 to .92 in this study. Method: The original study was longitudinal, non-experimental, quantitative and descriptive. A purposive sample of patients and caregivers were interviewed at six weeks, three and six months post-hospital discharge. In the current study, patient cognition, patient mobility and caregiver depression were analyzed using descriptive statistics to determine changes over time. Inferential statistics were used to determine the significance of the changes in levels over time. Next, data were categorized into high, average and low score tables to identify and describe patterns. A grouping technique, hierarchical cluster analysis was used to further identify and describe patterns of patient cognition, patient mobility and caregiver depression over time. Findings: There were non-significant changes in patient cognition, patient mobility, and caregiver depression scores over time. Further analysis identified and described a large array of patterns of patient cognition, patient mobility, and caregiver depression in the dyads over time, and highlighted three persistent prevalent patterns. Conclusions: 1. Descriptive statistics and inferential statistics indicated virtually no changes in patients and caregivers scores from 6 weeks to 6 months, yet informative patterns emerged after further analysis. This focus on patterns rather than prediction extended caregiver research by taking it in a new direction. 2. Pattern categorization and hierarchical cluster analysis identified and described a wide array of patterns in caregiver-patient dyads which changed over time. 3. Three prevalent caregiver-patient patterns were found. "Good patient mobility/Average caregiver depression" was prevalent at 6 weeks, 3 months, and 6 months in approximately half of the dyads. Future research may confirm this pattern is a predictable and expected pattern experienced by many dyads in caregiver-patient relationships. "Average patient cognition/Average caregiver depression" was prevalent in nearly one half of the dyads at 6 weeks and 6 months. This may be another predictably common pattern found among caregiver-patient dyads. Future research may find this pattern influences the caregiver-patient relationship over time. "Average patient cognition/Good patient mobility/Average caregiver depression" was the most prevalent pattern of all 3 variables at 6 weeks and 6 months and was found in 33% of the dyads. It indicated that during this study many dyads were not in extremely difficult caregiving situations. 4. Caregivers experienced symptoms of depression throughout the entire study. It is a variable that needs close analysis in terms of its influence on the caregiver-patient dyadic relationship. Implications: 1. An expanded view, from the individual patient and caregiver to a dyadic caregiver-patient relationship focus, and a new interpretation of the stress process within the dyadic caregiver-patient relationship are needed to further the development of theoretical knowledge of the process of caregiving over time. 2. Future researchers need to provide findings that demonstrate the stages and changes that develop within caregiver-patient dyads across time. Knowledge about prevalent patterns in dyadic caregiver-patient relationships may help clinicians predict and explain changes that may occur in the relationship over time. 3. Interventions such as anticipatory guidance and education about the relationship and changing patterns of stress may assist caregiver and patient dyads to negotiate through difficult times. 4. Gaps that need to be addressed in future caregiving research include the quality of the caregiver-patient relationship and how the relationship changes over time.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleIdentification and Description of Changing Patterns of Patient Cognition, Patient Mobility, and Caregiver Depression in the Caregiver-Patient Relationship Over Timeen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156822-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Identification and Description of Changing Patterns of Patient Cognition, Patient Mobility, and Caregiver Depression in the Caregiver-Patient Relationship Over Time</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Offner, Judith, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">BHS, Camden County Health Services Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nursing Specialist</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">JudyOffner@comcast.net</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this study was to describe and identify the changing patterns of patient cognition, patient mobility and caregiver depression within the context of Offner's theory of waxing and waning caregiver-patient relationships. Design: This descriptive quantitative study represented a secondary analysis from a study of caregiver responses to managing elderly patients at home. Population, Sample, Setting, Years: Of the 736 caregivers and patients in the original data set, 50 patient care-giver dyads had complete data and were used in the present study. The original sample was obtained from consenting caregivers and patients who were recruited at several urban Michigan hospitals. Patients in the current study were male (54%) or female (46%), married (64%), and widowed (30%). Many (74%) patients and caregivers cohabited. The average age was 78.5 years and ranged from 60-92 years. The majority of caregivers in the current study were female (86%), white (85%), spouses (62%) and daughters (26%). Most caregivers were married (84%) and their average age was 62 with the range from 27 to 92 years. Variables Studied: Patient cognition, patient mobility, and caregiver depression were selected to serve as quantifiable variables to illustrate changing patterns within the caregiver-patient dyad over time. The Patient Cognition Assessment Instrument, Patient Mobility Assessment Instrument, and Center for Epidemiological Studies' Depression Scale measured the variables. Cronbach alpha levels ranged from .66 to .92 in this study. Method: The original study was longitudinal, non-experimental, quantitative and descriptive. A purposive sample of patients and caregivers were interviewed at six weeks, three and six months post-hospital discharge. In the current study, patient cognition, patient mobility and caregiver depression were analyzed using descriptive statistics to determine changes over time. Inferential statistics were used to determine the significance of the changes in levels over time. Next, data were categorized into high, average and low score tables to identify and describe patterns. A grouping technique, hierarchical cluster analysis was used to further identify and describe patterns of patient cognition, patient mobility and caregiver depression over time. Findings: There were non-significant changes in patient cognition, patient mobility, and caregiver depression scores over time. Further analysis identified and described a large array of patterns of patient cognition, patient mobility, and caregiver depression in the dyads over time, and highlighted three persistent prevalent patterns. Conclusions: 1. Descriptive statistics and inferential statistics indicated virtually no changes in patients and caregivers scores from 6 weeks to 6 months, yet informative patterns emerged after further analysis. This focus on patterns rather than prediction extended caregiver research by taking it in a new direction. 2. Pattern categorization and hierarchical cluster analysis identified and described a wide array of patterns in caregiver-patient dyads which changed over time. 3. Three prevalent caregiver-patient patterns were found. &quot;Good patient mobility/Average caregiver depression&quot; was prevalent at 6 weeks, 3 months, and 6 months in approximately half of the dyads. Future research may confirm this pattern is a predictable and expected pattern experienced by many dyads in caregiver-patient relationships. &quot;Average patient cognition/Average caregiver depression&quot; was prevalent in nearly one half of the dyads at 6 weeks and 6 months. This may be another predictably common pattern found among caregiver-patient dyads. Future research may find this pattern influences the caregiver-patient relationship over time. &quot;Average patient cognition/Good patient mobility/Average caregiver depression&quot; was the most prevalent pattern of all 3 variables at 6 weeks and 6 months and was found in 33% of the dyads. It indicated that during this study many dyads were not in extremely difficult caregiving situations. 4. Caregivers experienced symptoms of depression throughout the entire study. It is a variable that needs close analysis in terms of its influence on the caregiver-patient dyadic relationship. Implications: 1. An expanded view, from the individual patient and caregiver to a dyadic caregiver-patient relationship focus, and a new interpretation of the stress process within the dyadic caregiver-patient relationship are needed to further the development of theoretical knowledge of the process of caregiving over time. 2. Future researchers need to provide findings that demonstrate the stages and changes that develop within caregiver-patient dyads across time. Knowledge about prevalent patterns in dyadic caregiver-patient relationships may help clinicians predict and explain changes that may occur in the relationship over time. 3. Interventions such as anticipatory guidance and education about the relationship and changing patterns of stress may assist caregiver and patient dyads to negotiate through difficult times. 4. Gaps that need to be addressed in future caregiving research include the quality of the caregiver-patient relationship and how the relationship changes over time.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T15:10:16Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T15:10:16Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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