How do culture and values influence the nature of the caregiving relationship between a Hispanic caregiver and a family member with Alzheimer’s?

Review of Journal Articles

Subject: Sociology
Journal Articles Review Instructions (15 points)
Find 3 refereed empirical (quantitative or qualitative) journal articles that address the effectiveness of social work treatment or interventions related to a topic of your interest. The articles should be in your expected area of concentration (CYF or CMH). Think ahead to the literature review assignment and link this assignment to it. Analyze them using the criteria below

For each article:
1. identify the research question,
2. research the approach (exploratory, descriptive, explanatory) and explain why,
3. describe the research design,
4. key findings,
5. conclusions
Each article review should be a minimum of 1-page, single-spaced. Include an APA style reference page that correctly identifies each article reviewed. Use PsycINFO, Medline, Sociological Abstract, Social Services Abstract, or some other literature database search engine (e.g. Google Scholar) to find relevant articles.

Required Format (each bold heading is required):
Article Title, Author and Publication Information (follow APA style manual)
Research Question
Research Approach
Research Design
Key Findings
Conclusions, including:
Usefulness to Social Work:
o Note any issues related to ethics & cultural competence, social justice/advocacy
o Include a rating on a scale of 1-10, with 10 being most useful and discuss the reasons for your ratings
Criterion Possible points
Using APA style, including accurate Reference List 2
Following requested format (using all the bold headings listed above) 2
Analyzing the articles using critical thinking skills 4
Demonstrating mastery of the research skills studied in class 2
Critiquing usefulness to SW & recommended future research 2
Using graduate level writing skills: grammar, spelling, punctuation, organization, and APA style reference page 3
Total Points 15
Running Head: Journal Articles
Assignment #1
Review of Journal Articles or near State University, East Bay

SW 6032: Section __
Stuart Hanson
Date here
Title, Author and Publication Information
Cox, C. & Monk, A. (1993). Hispanic culture and family care of Alzheimer’s patients.
Health and Social Work, 18, 92 – 100. Retrieved Saturday, April 14, 2007 from
the Academic Search Premier database.
Research Question
How do culture and values influence the nature of the caregiving relationship between a Hispanic caregiver and a family member with Alzheimer’s?
Research Approach
The descriptive approach included structured personal interviews with 86 caregivers of Alzheimer’s patients in New York City. Respondents were reached through staff members of senior centers, hospital social workers, directors of local Alzheimer’s programs, social service agencies, home care agencies, and the clergy of several predominantly Hispanic churches. Respondents had to be the primary caregiver of the patient. Interviews were conducted in Spanish in homes.
Research Design
Cultural impact on caregiving was measured using an earlier study. There were seven items, with responses using a Likert-type scale ranging from 1 = strongly agree to 5 = strongly disagree.
Patient status was evaluated using the Memory and Behavioral Problems Checklist. This instrument measures how behavior upsets caregivers with 30 items and a range from 0 = never occurs to 5 = occurred frequently in the past but no longer occurs. Caregiver status was measured in terms of physical health through self-reports and depression using the CES-D scale. The range is 0 – 60, with a score of 16 or more indicating symptoms of depression. A caregiver can obtain a high score by either having several symptoms at once or only a few over an extended period. The Burden Interview was also translated into Spanish to measure stress levels. The interview is composed of 22 items with responses ranging from 0 = not at all to 4 = extremely.
Sample
Respondents had to be the primary caregiver of the patient. Interviews were conducted in Spanish in homes. Demographics of the sample indicate that women composed the majority of the 86 Hispanic caregivers: (77.9 percent, n=67) and the Alzheimer’s patients (76.7 percent, n = 66). A majority of the caregivers were daughters, (46.5 percent, n = 40), spouses (23.3 percent, n = 20) and adult sons comprised 11.6 percent (n = 10) of the caregivers. Few caregivers or patients were born in the United States. Spanish was the predominant language, demonstrating the ethnic bonds in the community.
Data Collection
Data were collected using structured personal interviews with 86 caregivers of Alzheimer’s patients in New York City. Respondents were reached through staff members of senior centers, hospital social workers, directors of local Alzheimer’s programs, social service agencies, home care agencies, and the clergy of several predominantly Hispanic churches.
Key Findings
Religious observance played a central role in the respondents lives, 82.5 percent (n = 71) Catholic, 13.9 percent, (n = 12) Protestant and 3.4 percent (n = 3) Jehovah’s Witness.
Education level was low, 41.8 percent completed elementary school, while 13.9 percent had completed some high school and 10.4 percent had some college. Average income was below $15,000 a year, with only 40.6 percent of the caregivers employed. 29.4 percent of the caregivers left work to care for their relative.
Physical health, according to a majority of the caregivers, (68.6 percent), had not changed in the last year. However, more than a quarter of the respondents, (29.0 percent) felt their health had deteriorated, with most of the group (63.9 percent) received care for a chronic condition such as hypertension, emotional problems and heart ailments with half of the sample indicating that their physical condition interrupted with their care for their relative. The Memory and Behavior Checklist shows they are moderately impaired: 80.8 within the range of 0 to 150. Almost half of the caregivers turn to friends and family to confide their problems on a daily basis, but the same number had difficulty finding substitute care.
Parents expect children to live nearby to care for them while caregivers frowned on leaving work to care for their parents, they did not feel paying a professional to assist with care meant they shirked their familial responsibilities.
Regarding the CES-D and Burden Scales, the caregivers indicated they were clinically depressed and responded in the moderate range for burden. Time spent caring for their relative meant not enough time to care for themselves.
Conclusions (the authors’)
Familial relationships support care for the elderly among Hispanics, modeling the cultural values expected for the population. However, the caregivers did not seek formal support from doctors.
Usefulness to Social Work
Caregivers have demonstrated reluctance to seek counseling and therefore active outreach is vital. On a scale of 1 – 10, this study ranks 8. Interviews were conducted in Spanish using culturally competent guidelines. Case managers could build on the trust and openness that was displayed in the interviews. In addition, social workers can educate physicians and nurses about the guilt and stress that underlie the physical symptoms of nervousness that bring caregivers to the medical doctors in the first place. Social Workers also can inform medical professionals of cultural complexities.
One example of the complexity is the value of extended family that is unlikely to place a family member in a nursing home. Social workers must be sensitive to the feeling of guilt that might be raised if this suggestion is made. Interventions must include culturally competent awareness.
Recommendations for Future Research
Social workers can suggest counseling to Hispanics to convey that they have limitations to broaden their perspective to see beyond the family values that create burdens as caregivers. This will enable families to cope with the difficulties of caregiving. As a result of this study, one could initiate a study on the options for respite care which includes variables for religious or workplace support
Title, Author and Publication Information
Fitzsimmons, S. & Buettner, L. (2002). Therapeutic recreation interventions for need-
driven dementia-compromised behaviors in community dwelling elders. American Journal of Alzheimer’s Disease and Other Dementias, 17, 367 – 376. Retrieved Saturday, April 14, 2007 from the Psych Info database.
Research Question
Are at-home individualized recreational therapy interventions (TRI) effective for people with dementia and disturbing behaviors who would otherwise not want to leave their homes?
Research Approach
Researchers described specific interventions with an exploratory approach to determine if they led to calming agitated people and engaging passive people. Behavioral problems were identified in the community in terms of type and times of occurrence.
Research Design
The study used a pre-test/post-test experimental design with biofeedback measures to regulate physiological changes and each subject acted as his/her own control. Blood pressure and heart rate were measured and compared to a baseline. Video tape was also used three times during the test. Two intervention groups were randomly assigned: one received therapeutic recreation for two weeks while the second maintained regular homecare for two weeks and then engaged in the prescribed recreation program.
Sample
(not completed by student)
Data Collection
(not completed by student
Key Findings
Cohen-Mansfield Agitation Inventory indicated a decrease from the pre-test 1.87 to 1.76 to demonstrate improvement in the level of agitation. Passive behaviors improved as well as noted in the shift pre and post-test from 1.63 to 1.97, respectively. Day time behaviors were distinguished as agitated with a peak between 4 p.m. and 8 p.m. and passive with two peaks, between 10 a.m. and noon, and then 4 p.m. and 6 p.m.
Conclusions (authors’)
Keeping family members engaged is a major challenge when they are likely to be verbally or physically aggressive, wander or present as agitated. The introduction of activities that may carry over to other daily efforts is vital to maintaining elders at home. Cost for at-home therapy was estimated at $30 per hour for staff and $10 per week for supplies. Two caregivers reported that TRI delayed institutionalization which in Florida average cost is $4,500 a month.
Usefulness to Social Work
On a scale of 1 – 10, this study ranks an 8. To participate in the study, a guardian needed to provide signed consent for ethics consideration. This study provided helpful background for social workers to intervene in family discussions and help seniors age in place which is the predominant idea in the field. At the same time, 94 percent of the participants were white non-Hispanic and therefore the study is limited in relating to minorities.
Future Recommendations
Recreational Therapy Intervention (TRI) will be an effective means to serve elders who are reluctant to attend day care settings, to reduce agitation and increase involvement in daily activities. If adjustment to daily life improves and individuals remain in the community, insurance companies and the government may be persuaded to support the cost. Further research could determine the types of recreational activities that would best meet the needs of specific manifestations of dementia behavior.
Title, Author and Publication Information
Cheung, J., Kwan, A., Chan, S., Ngan, R., Ng, S., Leung, E., & Lau, A. (2005). Quality
of Life in Older Adults: Benefits from Caring Services in Hong Kong, Social Indicators Research, 71, 291-334. Retrieved Monday, April 30, 2007 from the CSA Illumina database.
Research Question
Do services like home care, daycare, nursing home, medical services and home delivered meals and improve social relationships and increase quality of life?
Research Approach
Because the sample (see below), this study was mainly descriptive.
Research Design
This study used qualitative (focus groups) and quantitative (survey) methods in which groups met to take a pre-test in focus groups to answer a core question: “What is a good life? Why do you think that?” 61 questions were derived from these answers to comprise the final measurement of quality of life, self-happiness, physical health and global quality of life. The test was further broken down into the following categories: Quality of cultural activities, Quality of work, Quality of accommodation, Quality of finance, Quality of friendship, Quality of life with community, with family.
Sample
3,000 older Chinese people in Hong Kong divided into three segments: the young old (65-74), old old, (75-84) and old older (85+). The respondents included users of social centers, residential care and community care. They were randomly selected to represent a continuum of care.
Data Collection
First, focus groups were convened to develop survey questions. Second, a survey was administered to the sample described above.
Key Findings
A person living in hostel scored highest with quality of life, but not with overall health. The elders who used none of the services scored highest on health. Users of day care centers displayed lowest levels of health. However, because the analysis did not control for background among elders, the significant difference does not truly indicate benefits or weakness of the services.
Conclusions (authors’)
Home care stands out as the greatest benefit in terms of cumulative use, chronic illness, and age and sex variables. In addition, home care includes the element of caring in terms of defining a close relationship through case management which includes self-empowerment and overall contributes to quality of life.
Usefulness to Social Work
On a scale of 1 – 10, this study ranks 9 in terms of comprehensive methodology and thorough review of variables facing the senior population. Evaluating quality of life is relevant for all ethnic populations and this study may pertain to other ethnic groups. The conclusions of this study reinforce the value of the role of social workers and case managers in the community. They provide a vital link for companionship to the disenfranchised, isolated seniors.
Future Recommendations
Volunteer involvement as well as home care relationships enables elders to weather changes in their surroundings. In terms of continued service, the nursing home provides medical care over a sustained period, although it includes short-comings attributed to loss of self-determination. If social care were introduced to the nursing home, then quality of life would be improved. One could conduct research based on where elders live as a variable to determine quality of life.
this is my subject
(domestic violence effect on children)

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