Unit:
Τομέας Ψυχικής Υγείας και Επιστημών ΣυμπεριφοράςLibrary of the School of Health Sciences
Author:
Mantzorou Marianna
Dissertation committee:
Ευμορφία Κούκια, Αναπλ. Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Αθηνά Καλοκαιρινού, Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Μαρίνα Οικονόμου, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Παναγιώτα Σουρτζή, Καθηγήτρια, Νοσηλευτική, ΕΚΠΑ
Αντώνιος Πολίτης, Αναπλ. Καθηγητής, Ιατρική, ΕΚΠΑ
Σοφία Ζυγά Αναπλ. Καθηγήτρια, Νοσηλευτική, Πανεπιστήμιο Πελοποννήσου
Νικόλαος Φώτος, Επίκουρος Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Original Title:
Διερεύνηση του στίγματος, των ειδών γνώσης και της εξουθένωσης των φροντιστών ηλικιωμένων με ανοϊκές συνδρομές
Translated title:
Examination of the stigma, kinds of knowledge and burnout of the carers of elderly people with dementia syndromes
Summary:
Introduction
Demetia is part of the life of millions of people worldwide but the poor understanding contributes towards the stigma that surrounds the disease with negative consequences for the integration and quality of care of the patients as well as the wellbeing of professional and family caregivers who undertake their care.
Aims
The present study aims at investigating whether professional and family caregivers of people with dementia stigmatize their patients and whether they experience burnout so as to find correlations between them and compare the two groups. Moreover, it aims at describing the kinds of knowledge used by qualified nurses and unqualified professional care givers caring for demented elderly people in nursing homes from their own perspective.
Methodology
A cross-sectional study of burnout experienced by nurses and family care givers as well as the stigma they attach to their patients, was carried out in a convenience sample of 171 geriatric nurses in 16 elderly care units and 153 pairs of patients and family care givers in 3 Dementia Day Care centers in Attica. The research tools used in the study were 3 questionnaires regarding social and demographic data of nurses, patients and family caregivers, the Maslah Burnout Inventory (ΜΒΙ) (Maslach and Jackson, 1981), [validation of Greek version by Anagnostopoulos and Papadatou (1992)], the Neuropsychiatric Inventory (ΝPI ΝΗ) (Cummings et al, 1994, Greek validation by Dr A. Politis) and the Family Stigma in Alzheimer’s Disease Scale (FS-ADS) [Perla Werner, Dovrat Goldstein and Jeremia Heinik (2011)], the Greek version of which was validated in the context of the present doctoral thesis. The scale was found to be a reliable tool for measuring stigma in dementia (Cronbach’s alpha 0,899 for the scale of professional caregivers and Cronbach’s alpha 0,854 for the scale of the family caregivers).
The statistical package SPSS v. 22 was used for analysis of quantitative data while the statistical significance level was defined as p<0,05. Descriptive statistics were initially generated for sample characteristics, correlations between variables were made through pearson (r) and spearman tests, comparisons between groups through the t-test, Μan-Whitney και Kruskal Wallis tests as well as the multiple linear regression model which was applied to determine the adjusted associations between independent variables under study and the stigma and burnout of professional and family caregivers. Also, a phenomenological qualitative study in a representative convenience sample of 11 nurses was carried out in order to explore the kinds of knowledge they use, the stigma they place upon their demented patients and the burnout they experience. Semi-structured, in depth interviews were carried out using the “critical incidence” technique while interpretative phenomenological analysis (IPA) was used for the interpretation of qualitative data.
Results
The present study showed that professional caregivers of demented persons in nursing homes, experience moderate levels of burnout while family caregivers taking care of a relative at home, experience moderate to low levels of burnout.
It also highlighted the presence of low to moderate level of stigma in the care of demented people by professional as well as family caregivers. The fact that cognitive, emotional and behavioral attributions of the 3 dimensions of stigma, were found to be independent predictive factors of the dimensions of burnout, shows that the stigma that they deposit on their demented person, contributes towards their burnout. It was found that family caregivers presented lower depersonalization levels in the Maslach Burnout Inventory (MBI) and higher levels of personal achievements in the same scale, possibly due to their close familial relationship and emotional involvement in providing care for their demented relative.
The qualitative part of the present study showed that time constraints inhibit acquisition of personal knowledge through a development of a personal relationship with the patients and discussions with them. Dealing with behavioral problems is performed through knowledge acquired by experience and discussions with more experienced nurses as well as by experimentation and in a lesser degree through scientific knowledge gained by formal education or personal continuing education. Little knowledge of the patient, lack of adequate educational preparation, patients’ stigmatization and nurses’ self-stigmatisation along with adverse working and organizational conditions, contribute to the development of professional burnout. Burnout manifests by emotional exhaustion with intense psychosomatic problems, lack of sense of personal accomplishments due to a sense of futility in providing care since the final ending is death which is often experienced as well as depersonalization since nurses reported they often felt treating their patients as objects.
Conclusion
Conclusions drawn from the current study with regard to the contribution of stigma towards the burnout of professional and family caregivers, can contribute to a better educational preparation of nurses caring for demented elderly people as well as carefully planned strategies to increase public awareness concerning dementia in order to achieve decrease of the stigma placed upon this condition. The development of a knowledge base in Gerontological Nursing may contribute to a better quality of care in dementia without the stigma which surrounds the disease that will take into account the individual needs of elderly people.
Main subject category:
Health Sciences
Keywords:
Stigma, Dementia, Burnout, Geriatric nurses, Professional carers, Family carers, Kinds of knowledge
Number of references:
754
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