bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACT-related Processes: Value-based Living Attenuates Meditating Relationships in Caregiver Stress Outcomes
Authors: Fauth Elizabeth Braungart , Novak Joshua , Aller Ty , Kelley Heather , Levin Michael 
Published: December 2021

Abstract
Associations between behavioral and psychological symptoms of dementia (BPSD), caregiver burden, and depressive symptoms are well-established, and these constructs are often targeted in interventions. Increasingly, dementia caregiver interventions are informed by mindfulness- and acceptance-based approaches, such as Acceptance and Commitment Therapy (ACT). In addition to standard outcomes, like burden and depressive symptoms, these interventions/therapies seek improvements in individuals’ psychological flexibility (e.g., cognitive defusion, present moment awareness, values-based living). Less is known how these constructs interact within well-established caregiver stress processes. We examined a moderated mediation model (N=161 dementia caregivers; PROCESS Procedure; SPSS Release 2.16.1), with BPSD frequency (Revised Memory and Behavior Problems Checklist) predicting depressive symptoms (10-item CES-D), mediated via caregiver burden (short Burden inventory). The moderator was the Values Questionnaire (Progress scale), and we controlled for gender, caregiver duration, age, income, and education. Results revealed that the indirect effect of BPSD on depressive symptoms through caregiver burden was weakened through higher progress toward values (moderated mediation significant at p&lt;.05). In essence, greater levels of living according to values dampened the effect of BPSD on depressive symptoms, through care-related burden. These findings are important because caregivers often cannot leave this role, requiring them to learn to live with the caregiving role in healthy ways. Value-based living and committed action toward values signify caregivers’ success at balancing care-related stress with other priorities, and psychologically adjusting to difficulties. Interventions that emphasize values-based living, like ACT, have promise for caregivers, offering healthy ways to psychologically adjust to, and live with, the experience.
Caregiving in Older Adulthood and Meaning in Life
Authors: Suntai Zainab 
Published: December 2021

Abstract
While most of the literature on caregiving in adulthood focuses on grandparenting, there is an increasing trend of older adults providing care to an adult care recipient. Older caregivers are often females who are providing care to a spouse with medical conditions and are often doing so while coping with their own functional limitations, with limited support. Within the older adult literature, studies have captured the strain experienced by caregivers of older adults, who are often burdened by the loss of time and opportunity as a result of caregiving. For caregivers in older adulthood however, caregiving may be an avenue to remain engaged and active, and a way to have purpose in life. Therefore, the purpose of this study was to examine the association between caregiving in older adulthood and meaning in life. Data from the 2018 National Health and Aging Trends study were used, which is an annual longitudinal panel survey of Medicare beneficiaries in the United States. Chi square tests were used for bivariate analyses and a logistic regression model was used to predict meaning in life based on caregiving status. After accounting for all other explanatory variables, caregivers were 50% more likely to have meaning in life compared to non-caregivers (OR=1.501, CI= 1.493-1.510). This indicates that caregiving can be a form of meaningful/productive engagement for older adults and interventions should focus on providing adequate emotional and financial support to older caregivers.
Resilience in Family Caregivers of Adults With Autism Spectrum Disorder: An Integrative Review of the Literature
Authors: Chakurian Daphne 
Published: December 2021

Abstract
Care of adults with Autism Spectrum Disorder (ASD) is a public health priority and costs are projected to be 549 billion US dollars by 2025. Middle and older adult FCGs of adults with ASD often provide lifelong care, experience chronic stress, consequently, are at risk of poor mental health and QOL. An integrative review examined factors associated with resilience in studies of middle and older adult FCGs of adults with ASD. A comprehensive literature search found 10 reports of 8 studies published in peer-reviewed scholarly journals before October 13, 2020. Studies and/or reports of factors associated with resilience in middle and older adult FCGs of adults with ASD were examined using PRISMA, and quality checklists. Some 340 articles met search criteria, 14 were fully reviewed, and 10 were included. Findings suggest FCGs of adults with ASD show capacity for resilience consistent with research on FCGs of children with ASD significant chronic stress. A broad range of resilience factors were studied, and resilience was associated with positive social support, higher QOL, self-efficacy, and problem and meaning-focused coping styles. There is a dearth of research on middle and older adult FCGs of adults with ASD. Increased reporting of social determinants of health and participation of underrepresented groups is needed. Future research must address FGC heterogeneity and specify theoretically grounded conceptual and operational definitions of resilience. Identifying resilience factors is necessary for intervention studies to enhance resilience.
Effectiveness of Transitional Care from Hospital to Home in Frail Older Adults: A Systematic Review
Authors: Lee Ji Yeon , Yang Yong Sook , Cho Eunhee 
Published: December 2021

Abstract
Frail older adults are at high risk of negative consequences from hospitalization and are discharged without completely returning to their pre-existing health status. Transitional care is needed to maintain care continuity from hospital to home. This systematic review aimed to examine transitional care for frail older adults and its effectiveness. The Cochrane guidelines were followed, and search terms were determined by PICO: (P) frail older adults, not disease-specified; (I) transitional care initiated before discharge; (C) usual care; and (O) all health outcomes. Four databases were searched for English-written randomized controlled trials (inception to 2020), and eight trials were ultimately included. Frail older adults in eight trials (1996–2019) totaled 2,785, with a mean sample size of 310. The intervention components varied from hospital care (e.g., geriatric assessment, discharge planning, rehabilitation) to follow-up care after discharge (e.g., home visit, phone follow-up, community service). Most measured outcomes were readmission (n = 7), function (n = 4), quality of life (n = 4), self-rated health (n = 3), and mortality (n = 3). Statistical significance was reported in the following number of trials: readmission (n = 2), function (n = 2), quality of life (n = 1), self-rated health (n = 3), and mortality (n = 0). The effectiveness of the intervention on each outcome was inconsistent across the trials. Varied transitional care between hospital and home was implemented to improve health status; however, its effectiveness was controversial. A novel, yet evidence-based approach is needed to develop transitional care interventions for these vulnerable populations.
Older cancer survivors living with financial hardship in China: The Influence of Confucian Family Values
Authors: Su Mingzhu , Liu Li , Yue Hanlin , Zhang Jiajun , Yao Nengliang 
Published: December 2021

Abstract
Background: Financial hardship has not been well studied among older cancer survivors, despite its debilitating effects on their health and well-being. Aim: To describe the lived experience of older Chinese cancer survivors and explore the financial impacts following a cancer diagnosis. Design: A qualitative study conducted using semi-structured interviews with patients and family caregivers. Methods: We individually interviewed twenty-one cancer survivors (aged □ 60) with financial hardship and twenty family caregivers in Shandong province between August 2020 and January 2021. A content analysis was performed by multiple coders. Findings: Confucianism culture and the Chinese health system considerably impact the construct of financial hardship and its components. Four main categories were revealed:(1) healthcare providers were reluctant to discuss the diagnosis and costs of care with cancer patients; (2) financial transfer from adult children to older parents became prevalent after a cancer diagnosis;(3) cancer-related financial worries and stress spilled out into children's family; (4) coping and adjustment strategies were taken by the extended family. Conclusion: Both older cancer survivors and their adult children experienced financial distress mediating through filial piety in China. Instruments are needed to screen for cancer-related financial hardship adapted to the healthcare system and Confucian family values. Key words: Cancer survivors; older; financial hardship; qualitative; China
Policy Design and Consumer Direction: Cross-country Comparisons on Consumer-directed Care Programs
Authors: ZHANG Jinbao , WANG Julia Shu-Huah , Chen Yu-Chih 
Published: December 2021

Abstract
Objectives: The consumer-directed care (CDC) program aims to maximize health outcomes by offering older adults more control, choice, and flexibility over the care services they received. However, countries may operate CDC programs in different ways based on heterogenous sociostructural systems. We proposed a comparative framework to evaluate three dimensions of CDC—control and direct services, variety of service options, and information and support—and analyzed how countries varied in their policy design to achieve consumer direction. Methods: Using cross-national document analysis, we analyzed eleven CDC programs from seven selected countries (Netherlands, United States (US), United Kingdom (UK), Germany, China, Australia, and Spain) with five CDC care regimes. A total of fourteen indicators capturing three dimensions of CDC programs was developed. We further used these indicators to evaluate and compare similarities and differences of policy features across countries using descriptive statistics and graphical approaches. Results: CDC programs in the Netherlands, Arkansas, and the UK ranked at the top in consumer direction. All countries except Germany employed a “service-based” principle in determination of service type. Training care workers was in the most widespread use to assure quality of care. Merely the UK and Germany integrated CDC and conventional agency care without restrictions. Representative with relevant support was only available in the UK and Netherlands. Discussion and Implication: CDC models involve multi-faced aspects, rather than dichotomies and discrete entities. Implications include the need for a systematic reflection with our developed framework and enriching variety of service options to promote consumer direction.
Acceptance Commitment Therapy Intervention for Custodial Grandfamilies: A Virtual Implementation
Authors: Faulhaber Ella , Custis Meghan , Heupel Emily , Lee Jeongeun 
Published: December 2021

Abstract
Custodial grandfamilies often face challenges, such as psychological distress, parenting burden, and grandchildren showing internalizing and externalizing behaviors. Given their circumstances, effective training and education is critical to provide a supportive family environment for both custodial grandparents and custodial grandchildren. The aim of this study was to develop, pilot and evaluate a psychosocial intervention for custodial grandfamilies. The program, interACT, was implemented virtually due to restrictions related to COVID-19. It is an intervention for custodial grandparents (CGPs) and custodial grandchildren (CGC) to improve psychological wellbeing and life skills. Participant eligibility was determined by grandfamilies having Iowa residency and legal guardianship or custody of an 8-12 year old grandchild. The program utilizes the Acceptance and Commitment Therapy (ACT) framework, focusing on psychological flexibility, acceptance, and psychosocial resilience for CGPs and CGC. The program used techniques such as mindfulness, self-compassion, and decision-making skills. During the pilot program stage, participants were divided into CGPs and CGC groups, and completed self-paced weekly 45 minute long modules through a program website. To enhance online session experience, Extension staff facilitated hour-long Zoom calls to discuss module contents and foster peer connection for both groups. Findings will be available at the conclusion of the pilot program. We expect to find increased psychological well-being and improved life skills for both groups right after the implementation of the ACT. Findings and limitations will be discussed with practical implication for program implementation via virtual delivery for the current custodial families. Future studies could extend current curriculum to other populations.
Virtual Empowerment Training: Reaching Grandparent Caregivers During COVID19
Authors: Cox Carole 
Published: December 2021

Abstract
COVID-19 has had a devastating impact on minority populations in the United States who have disproportionately been at risk of getting the virus, having severe illness, and dying from it, with these risks most pronounced for older adults. The impact has been particularly severe on the more than on the more than 2, 7 million grandparents raising their grandchildren in the United States. Covid-19 has added profound strains to these families as they struggle with resources and isolation, frequently without assistance as well as the challenge of helping children to navigate online learning. The Virtual Empowerment Training Project, developed as a 7 session pilot program for low income grandparent caregivers in New York includes classes that strengthen parenting, communication, coping with loss and grief, and community empowerment. Participants were given ipads and computer training prior to classes, all conducted through Zoom. Initial data from the 56 participants (M age = 62, Race/ethnicity=Black, 79%, Hispanic, 16%, Income annual 41%&lt;$15,K ) indicate improvement, i.e. a lessening of Negative Affect regarding the grandchild (p &lt; .01) in the quality of their relationships with their grandchildren while also experiencing a decline (p &lt; .01) in their sense of parental efficacy, possibly reflecting their becoming more critical of their own parental skills. Participant evaluations of the course were overwhelmingly positive, with more than 90% finding it extremely helpful, valuable, and eager to share it with others and to become more involved in improving the lives of grandfamilies..
Development of Online Child Support Activities by Older Adults; An Action Research During the COVID-19 Pandemic
Authors: Takase Mai , Ogino Ryogo , Nitanai Ryoichi , Goto Jun 
Published: December 2021

Abstract
Japanese communities have been attempting a novel type of childcare support, wherein community-dwelling older adults form a specialized group (support group) that aims to provide child support activities. Before the COVID-19 pandemic, the group gathered children and mothers in community spaces and conducted events. However, on-site support had to be halted due to the pandemic. In this study, we report a case of action research aimed at shifting the activities online. First, a suitable online support plan was explored by hosting several discussions with child-rearing mothers. A questionnaire survey was then conducted to determine the most-sought intervention contents (N=19). Finally, based on the results, an intervention was conducted. As a result of the discussions, the hosting of online programs was set as the main goal. Out of the ten activities studied, the three most popular activities were programming (n=17), English conversation (n=16), and science workshop (n=15). Based on the results, an online science workshop that built a Bottleium, a small aquarium using a bottle, was hosted. Eight children participated in the event. A post-activity survey revealed that all participants attended the online activity for the first time, and the parents were happy to have joined the activity that entertained their child during the quarantine period. Furthermore, focus group interviews were conducted with the support group; they reported being satisfied with the outcome and recognized the importance of their role as member of support group. The results suggest the positive effect of this project on both older adults and the children.
Do young adults see value in advance directives?
Authors: Stone Arianna , Young Yuchi , Perre Taylor , Chung Kuo-Piao , Chen Ya-Mei 
Published: December 2021

Abstract
Many Americans avoid end-of-life care planning; only 26% have completed an advance directive (AD). An AD promotes end-of-life care with dignity allowing individuals to make end-of-life treatment and care decisions before they are unable to do so. Previous studies related to ADs are focused on older adults with serious illness or people with functional/mental disability. The objective of this survey is to better understand young adults' knowledge of and attitude toward ADs and their preferences for ADs related to treatment and care options. Methods. Participants include graduate students (n=25) attending a state university in New York State (NYS). Data were collected using two ADs (Five Wishes; Medical Orders for Life-Sustaining Treatment (MOLST)) and one survey questionnaire. Summary statistics and multivariate models will be used to address the study aims. Results. Preliminary results show the average age was 23 years, 72% were female, 48% White, and 44% Black. The majority of young adults hadn’t completed an AD; however, their attitude toward ADs was positive; the majority believe it is important to have an AD prepared at their current age; and they believe young adults would willing to fill out ADs. Young adults can make difficult treatment and care decisions when the situation requires it. Conclusion. The study findings can be useful to policy makers, healthcare providers and other stakeholders in promoting population-based healthcare decision-making. Limitation. Participants were recruited from one university in NYS; thus, the study results may be generalized to a population sharing similar characteristics.
Cognitive Changes in Older Adults Following a Stepped Care Intervention for Late-life Depression
Authors: Zhang Anna Y , Lu Shiyu , Liu Tianyin , Leung Dara K Y , Wong Gloria H Y , Lum Terry Y S 
Published: December 2021

Abstract
Older adults with depression may manifest cognitive decline and treating depression may maintain or improve cognition. However, cognitive outcomes could be overlooked in non-pharmacological interventions for depression. This analysis investigated cognitive changes in a stepped-care intervention (Clinical Trial ID: NCT03593889) and the potential association with individual depressive symptom change. The community-dwelling older adults at risk of or with depressive symptoms without significant cognitive impairment (n=802) were assigned to intervention group (n=644) and control group (n=138). Depressive symptoms and cognitive functions were measured using Patient Health Questionnaire-9 and Cognitive Montreal Assessment-5 minutes protocol, respectively. Paired-t-Test showed significant improvements in overall cognition and attention in both intervention and control groups, but the improvements of language fluency (Intervention: MD=-0.51 p&lt;0.01; control: MD=0.14, p=0.500) and orientation (Intervention: MD=-0.22 p&lt;0.05; control: MD=-0.11, p=0.229) only displayed in intervention group. As control group had better cognition at baseline, linear mixed-effects model analysis was used to compare between-group difference. Intervention group had no significant cognitive improvement after adjusting the covariates but a potential improvement in language fluency (Coef. =0.442, SE=0.247, p=0.074). A linear regression analysis in intervention group indicated that reduction of concentration problem (β=0.106, p&lt;0.05) and retardedness (β=0.117, p&lt;0.01) under the symptomatology of depression were associated with the improvement of language fluency. In this group of older persons without significant cognitive impairment, there is no clear evidence of global cognitive benefits in a stepped care depression intervention, although there may be improvements in certain cognitive domains, which may be related to improvements in cognitive aspects of depression.
Emotion regulation profiles of development of depressive symptomatology: a longitudinal study.
Authors: Paniagua Teresa , Fernández-Fernández Virginia , Molina Martínez MªÁngeles 
Published: December 2021

Abstract
Introduction:COVID-19 pandemic has had a psychological impact on the eldest population. The aim is to analyse whether there are differences depending on the emotional regulation profile shown by a group of older people 6 months before the pandemic and the depressive symptomatology of these people at the same time, during home confinement and 8 months later. Method:Longitudinal study, sample of people over 65, three evaluation measures: WAVE1 (6 months before COVID-19,N=305;M=73.63;58.9% women), WAVE2 (house confinement;N=151;M=73.14;59.6% women) and WAVE3 (8 months later;N=91;M=72.62;64.70% women). We measured depressive symptomatology (CES-D; Radloff, 1977) and nine emotional regulation strategies (CERQ-S; Garnefski et al., 2001; Carvajal et al., 2020), with which 3 clusters were preset (after dendogram inspection and K means analysis). Three mean difference analyses (one-factor ANOVA) were performed taking as factor profiles and as outcomes variables depression in each wave. Results:profile 1, people use adaptive cognitive-emotional regulation strategies; profile 2, those with low levels of strategies (adaptive and maladaptive); profile 3, high scores in maladaptive strategies. Statistically significant differences between profiles 1 and 3, in the pre-confinement depression variable (F'2,91=6.18;p=.00) and during confinement (F'2,91=4.02;p=.02). Profile 3 higher depressive symptomatology (x̄1=17.16;x̄2=16.80) than 1 (x̄1=8.41;x̄2=9.65). Differences between profile 1 and 2 and 3 in depression 8 months after confinement (F’2,91=4.02;p=.02). Profile 1 lower levels of depression (x̄3=98.00) than 2 (x̄3=15.78) and 3 (x̄3=14.20). Profiles explain 12.3%, 8.4% and 12.5% of the depression variance in each wave. Conclusions:a "protected profile" (1), a "medium-term vulnerable profile" (2) and a "vulnerable profile" (3) to the development of depressive symptomatology.