Background: Managing the burden of care for patients with chronic debilitating diseases is an important issue. Herein, we assessed the burden in primary family members caring for uremic patients on maintenance peritoneal dialysis. Methods: One hundred seventy caregivers and 170 patients were recruited. Self-perceived scoring along the Zarit Caregiver Burden Scale (ZCBS), World Health Organization Five-item Well-Being Index (WHO-5), and Warwick–Edinburgh Mental Well-being Scale (WEMWBS) were determined for caregivers. Results: There was an inverse relationship between ZCBS and WHO-5 or WEMWBS scores in caregivers, suggesting that the higher the burden, the lesser the self-perceived well-being. One hundred two of 170 caregivers (60%) reported mild to moderate burden, indicating a common presence of mild to moderate caring-related mental and physical stress. Moreover, 31 caregivers (18.2%) reported moderate to severe burden. Several patient disease factors, including diabetes and frailty, increased caregiver burden, while insurance coverage and out-of-pocket medical costs were also positively correlated. Caregivers who lived with patients and spent longer hours in caring-related activities had higher burden scores, while regular exercise seemed to partially alleviate the burden. Conclusion: Our study clearly showed that caring for patients with maintenance peritoneal dialysis caused physical, mental, and social burden in family caregivers, with the extent of the stress being influenced by patients’ disease severity and other demographic factors in both patients and caregivers.
ObjectivesThe aim of this study was to perform a bibliometric analysis of publications related to perinatal palliative care to identify scientific output and research trends at a global level.MethodsThe Web of Science Core Collection database was searched to retrieve publications focusing on perinatal palliative care published between 2001 and 2020. All retrieved publications were identified by title and abstract for their relevance to perinatal palliative care. These eligible publications were extracted from the following data: title, abstract, year, keywords, author, organization, journal and cited literature. VOSviewer software was used to conduct bibliographic coupling, coauthorship, and cooccurrence analyses and to detect publication trends in perinatal palliative care research.ResultsA total of 114 publications concerning perinatal palliative care were included. The annual number of publications has increased dramatically in recent years. The United States has made the largest contribution to this field with the majority of publications (68, 59.6%) and citations (1,091, 70.5%) and with close collaborations with researchers in Canada, Portugal and Australia. Wool C and her institution, York College of Pennsylvania, are the respectively, most prolific author and institution in this field, publishing 18 papers (15.8%). Journal of Palliative Medicine is the leading and main journal in this field. According to the cooccurrence network analysis, five main research topics were identified: the candidates for PPC, service models and forms, framework components, parental perspectives and satisfaction, and challenges and needs of health care providers.ConclusionThe findings of this bibliometric study illustrate the current state and global trends of perinatal palliative care for the past two decades, which will help researchers determine areas of research focus and explore new directions for future research in this field.
Objectives. Midwives are at high risk of presenteeism, which may impact the quality of midwifery and maternal and infant health outcomes. However, no research has been conducted to investigate the relationship between workload, traumatic stress, psychological detachment, and presenteeism among midwives. This study, therefore, aimed at exploring the mediating effects of psychological detachment on workload, traumatic stress, and presenteeism among midwives. Method. A multicenter cross-sectional study was conducted among 547 midwives in Jiangsu Province. Participants completed the National Aeronautics and Space Administration task load index, traumatic stress impact subscale for midwives, psychological detachment scale, and Stanford presenteeism scale and provided sociodemographic information. The mediating effects of psychological detachment were assessed using Mplus. Results. The mean score of midwives’ presenteeism was 17.09 ± 3.56. Presenteeism was positively associated with both workload and traumatic stress (both P < 0.01 ) and negatively associated with psychological detachment ( P < 0.01 ) among midwives. Psychological detachment partially mediated the relationships between (a) workload and presenteeism ( β = 0.005, P < 0.05 ) and (b) traumatic stress and presenteeism ( β = 0.006, P < 0.05 ), with mediating effects of 11.90% and 10.00%, respectively. Conclusions. Presenteeism among midwives is at moderately high levels and requires attention from nursing managers. Psychological detachment is a mediating variable of the relationship between workload, traumatic stress, and presenteeism among midwives. Implications for Nursing Management. This study has implications for decreasing midwives’ presenteeism in practical terms. Specifically, it is crucial that care managers attempt to adjust midwives' work patterns, reduce their workload, and provide organizational support for work-related traumatic stress. Moreover, our findings also indicate that psychological detachment is probably an essential element that is worthy of attention.
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