Aims To examine prevalence, types, challenges and the impact of medical/nursing tasks (MNT) on caregivers of older adults with dementia. Background Medical/nursing tasks have been perceived as a professional healthcare role; however, research shows that many caregivers of older adults with dementia perform those tasks in the home, such as giving injections, tube feedings or operation of medical equipment. Little is known about the caregivers’ challenges in engaging in these MNT. Design Integrative review. Methods Ovid MEDLINE, CINAHL, PsycINFO and Web of Science databases were searched to explore MNT among caregivers of older adults with dementia who lived in a community setting. Four quantitative and nine qualitative studies published between 1980–2018 were included. Overall, process of the review was guided by PRISMA. Results About 67% of U.S. caregivers of older adults with dementia performed MNT, including managing multiple medications, wound care and nutritional management. Care recipients' cognitive impairment complicated the provision of those tasks due to their limited cognitive functioning, behavioural changes, comorbidities and complex medication regimen. Insufficient information and training from healthcare professionals as well as caregivers’ age and their own health problems made performance of those tasks even more challenging. As a result, caregivers frequently suffered from emotional distress such as worrying, anxiety and sleep disturbance. Conclusions Medical/nursing tasks have become one of the daily tasks of caregivers of older adults with dementia within the home. However, the tasks are difficult and complicated, and inadequate support from healthcare professionals may compromise the caregivers’ well‐being. Relevance to clinical practice Healthcare professionals should provide education and should be aware of caregivers’ needs related to MNT. Structured‐medical information, skill‐based instructions and hands‐on training may be beneficial to decrease the caregivers’ distress from MNT.

Aims(a) To evaluate the effectiveness of different types of psychosocial interventions on the health‐related quality of life among caregivers of individuals with dementia and (b) To present an overview and assessment of the quality of the most recent intervention studies.DesignA systematic review and meta‐analysis.Data SourcesMEDLINE, CINAHL, PsycINFO and Cochrane Library electronic databases were searched to find randomized controlled trials (RCTs) published from 2005 ‐ 2017. Using a Boolean search, the key words ‘caregivers’, ‘dementia’ and ‘quality of life’ were combined. The search was completed in January 2018.Review MethodsA total of 26 RCTs were included. Intervention details such as content, mode of delivery and duration were reviewed, and each study's risk of bias was assessed. The effectiveness of each type of intervention was calculated using the Hedges G and a random‐effects model.ResultsMulticomponent interventions, cognitive behavioural therapy and complementary alternative medicine therapy showed significant effects on improving caregiver's health‐related quality of life. Psychoeducation, social support, case management and cognitive rehabilitation therapy failed to produce significant effects.ConclusionVia this evidence‐based systematic review, multicomponent interventions addressing a variety of caregiver needs can be an effective method for enhancing caregiver health‐related quality of life. Further large number of studies are needed to verify this study results.ImpactThe findings of this study inform clinicians which interventions are effective in improving caregivers’ health‐related quality of life. Defining a standardized protocol for multicomponent interventions will be helpful for clinicians to apply the intervention.

Background Home healthcare workers (HHWs) provide medical and nonmedical services to home‐bound patients. They are at great risk of experiencing violence perpetrated by patients (type II violence). Establishing the reliable prevalence of such violence and identifying vulnerable subgroups are essential in enhancing HHWs’ safety. We, therefore, conducted meta‐analyses to synthesize the evidence for prevalence and identify vulnerable subgroups. Methods Five electronic databases were searched for journal articles published between 1 January 2005 and 20 March 2019. A total of 21 studies were identified for this study. Meta‐analyses of prevalence were conducted to obtain pooled estimates. Meta‐regression was performed to compare the prevalence between professionals and paraprofessionals. Results Prevalence estimates for HHWs were 0.223 for 12 months and 0.302 for over the career for combined violence types, 0.102 and 0.171, respectively, for physical violence, and 0.364 and 0.418, respectively, for nonphysical violence. The prevalence of nonphysical violence was higher than that of physical violence for professionals in 12 months (0.515 vs 0.135) and over the career (0.498 vs 0.224) and for paraprofessionals in 12 months (0.248 vs 0.086) and over the career (0.349 vs 0.113). Professionals reported significantly higher nonphysical violence for 12‐month prevalence than paraprofessionals did (0.515 vs 0.248, P = .015). Conclusion A considerable percentage of HHWs experience type II violence with higher prevalence among professionals. Further studies need to explore factors that can explain the differences in the prevalence between professionals and paraprofessionals. The findings provide support for the need for greater recognition of the violence hazard in the home healthcare workplace.

Background Caring for a family member with dementia puts caregivers at risk for depressive symptoms. Yet, interventions with promising effects on caregiver depressive symptoms are not well documented. Aims This review aimed to examine the quality and effectiveness of interventions to reduce depressive symptoms reported by caregivers of people with dementia. Design A systematic review and meta-analysis of nonpharmacological intervention trials was conducted. Methods The electronic databases searched included MEDLINE, CINAHL, and PsycINFO to find randomized controlled trials published between 2007 and 2017. A total of 31 randomized controlled trials were included in the meta-analysis. Results Cognitive-behavioral therapy (838 participants) showed a large, significant effect (standardized mean difference = −0.905; 95% CI = (−1.622, −0.187); p = 0.013) and mindfulness interventions (186 participants) showed moderate, significant effects (standardized mean difference = −0.578; 95% CI = (−0.881, −0.275); p < 0.001) on decreasing caregiver depressive symptoms, while psychoeducational interventions demonstrated small but significant effects (standardized mean difference = −0.244; 95% CI = (−0.395, −0.092); p = 0.002). Emotional support, cognitive rehabilitation, and multicomponent interventions showed less than small or nonsignificant effects related to depressive symptoms among caregivers. Conclusion Cognitive-behavioral therapy interventions, which focus on diminishing negative thoughts and increasing positive activities, can effectively decrease depressive symptoms for caregivers of individuals with dementia. Future research is recommended to assess the long-term effectiveness of cognitive-behavioral therapy in this population.

Study findings highlight the potential benefit of a static stretching exercise on central arterial stiffness, an independent predictor of cardiovascular morbidity. Static stretching exercise conducted in the sitting position may be used as an effective intervention to reduce cardiovascular risk after a cardiac event or for patients whose sympathetic function should not be overly activated or whose gaits are not stable.