|SYMPOSIUM (THEME SECTION: CAREGIVING AND CAREGIVERS)
|Year : 2016 | Volume
| Issue : 1 | Page : 40-41
Various aspects for research focus among caregivers: Past, present, and future
Division of Non-Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
|Date of Web Publication||17-Feb-2016|
Dr. Ravinder Singh
Scientist ICMR Headquarters, New Delhi
Source of Support: None, Conflict of Interest: None
Do we need any research on caregivers and caregiving and whether research helps the field of care? During last three decades, there has been a tremendous change in health care service delivery, as well as the development of sustainable policies on long-term care. The research identified need for the training of health professionals for psychiatric care, preventing and managing chronic diseases, and developing people-friendly services and health care settings. This review further highlights how to sensitize policy makers to improve the quality of life of persons with mental health problems and to caregivers and how to prioritize our research in the area of caregiving.
Keywords: Caregiver, policy, research
|How to cite this article:|
Singh R. Various aspects for research focus among caregivers: Past, present, and future. Indian J Soc Psychiatry 2016;32:40-1
| Introduction|| |
Caregivers may be formal or informal. Formal caregiver is an individual such as physician, nurse, or social worker, who assists in the identification, prevention, or treatment of an illness or disability. Any individual, such as family member or guardian, who takes care of a child or dependent adult, is called as an informal caregiver. In general, the majority of the care to the chronic patients is provided by the informal caregivers. Spouse, father, mother, son, daughter, or daughter-in-law is common relative providing care to the patients. Do we need any research and whether research helps the field of care? The answer to this question lies in the literature review, which shows that during last three decades, the health care providers have tremendously benefitted from the research, and this has helped them to streamline care. It has prepared health providers and societies to meet the needs of people with different diseases. It has also helped in directing our policies to focus toward bringing in healthy, independent, and productive populations. This was also instrumental toward formulating sustainable policies on long-term care (LTC). The research identified need for the training of health professionals for psychiatric care, preventing and managing chronic diseases, and developing people-friendly services and health care settings.
| Major Factors Affecting Health|| |
Major factors affecting health are poverty, unemployment and income adequacy, education, access to health services, and environmental factors such as housing and water quality. World Health Organization has termed these factors as social determinants.  The actions in social determinants have created healthier population as evidenced by general improvements in life expectancy, mortality rates, and other measures. These factors are associated with the physical, social, and economic environments in which people live and influence the health through the people's living conditions and quality of life (QOL). These conditions are income or wealth and its distribution, childhood care, education, employment and working conditions, unemployment and job security, food security, health care services, housing, social exclusion, culture, religion, and social safety nets. LTC of the chronically ill patients is affected by all these factors as lack of resources would lead to diminished care and affecting QOL negatively.
| Challenges with Long-term Care of Chronic Patients|| |
Challenges with LTC of chronic patients include improving QOL. This means, the QOL of such patients is not as good as normal populations. This becomes duty of the caregivers to help them have respectable QOL. Other challenge is to increase the number of illness- and disability-free years. Constant care and accessible health care facilities have increased illness- and disability-free years. Other focus of the caregivers (formal and informal) remains the productive and independent lives for chronic patients. Provision of accessible health care facilities and assistive devices are very crucial for the productive and independent lives. Challenges with persons suffering from mental health problems are different from other chronically ill patients as their thinking and decision-making capabilities are affected. Taking care of such patients is very challenging for both formal and informal caregivers. These patients are not able to take part in socioeconomic development, there are gender issues in caring such patients, and most of these diseases affect their lifestyle and are generally chronic in nature. Manpower availability is very scarce in countries such as India. Intervention programs/activities are difficult to develop and implement as there are legal and moral issues. Systems for health management are lacking. Quality of existing health facilities is very poor, and updating of health care facilities is a mammoth task. People are not using these health services at grass-root level. It is very difficult to collect data on mental health problems, especially among certain populations.
| Goals for Research Priorities|| |
Research on caregivers and issues related to them should have a goal for promotion of lifestyle changes, creation of supportive environments, and the provision of appropriate support services.
| Opportunities for Research in India|| |
Large population and its density provide us with scope of easy availability of universe, huge scope of intervention if identified at earlier stages, change in lifestyles for positive health, and diverse morbidity profile (including nutritional and lifestyle) for different intervention strategies are some of the opportunities for research on caregivers. India is the second largest country in the world as far as its population is concerned.
| Past Experiences|| |
Family caregiving emerged as an important area of research in the 1980s. Research over the past several decades has yielded a wealth of information on interventions to support caregivers and improve their health and well-being. A number of excellent reviews in the literature describe these intervention programs and their effectiveness. A widely cited paper by Zarit et al.  represented one of the first empirical papers on family caregiving. Caregiving is also an area of research that has inspired both basic and applied research, for example, on the impact of different kinds of social support on caregivers' well-being; and evaluating the efficacy of specific caregiver interventions on the health of their patients.  Research has shown that there is marked difference among caregivers and noncaregivers with regards to gathering health information online, particularly about medical problems, treatments, and drugs. It was seen that more number of caregivers searched for health information online as compared to the noncaregivers. Caregivers also gathered health information offline, from clinicians, friends, family, and others who share the same health condition. They also searched online to specifically figure out what condition they or someone else is dealing with. They checked online reviews about drugs and other treatments and tracked their own weight, diet, exercise routine, or other health indicator. Caregivers read online about someone else's personal health experience and others with similar health concerns (Caregivers read the experiences of others with dual motivations either to find more information about handling caregivers' stress or their loved one's health challenges).
| Present Research Interests|| |
Currently, researchers across the globe are looking at descriptions of the prevalence of caregiving and assistance provided by caregivers. There are studies focusing on the psychological, social, health, and economic impact of caregiving. Studies of individual differences in response to caregiving are also an area of focus of some researchers. People are looking at the effects of interventions on the outcome of such conditions. Some studies have looked into impact of public policies on caregivers. Caregiving for specific conditions or disabilities and populations has also been looked into.
| Methodologies Issues to be Considered by Current and Future Researchers|| |
Review the literature should be done carefully to prevent repetition of areas which have already been well-studied. Researchers should understand the methodological trade-offs that affect the feasibility of conducting certain kinds of studies. Consider key considerations that often compel caregiving researchers to make tough choices about the questions they wish to study.
| The Way Forward|| |
Research should sensitize policy makers about policy measures to improve the QOL of persons with mental health problems and to caregivers about the likely scenario of mental illnesses through media campaigns, school curriculum, and enhancing the possibilities for intergenerational understanding and cooperation. Some case studies and good working models of care should be studied and widely disseminated.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 1980;20:649-55.
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