Health promoting behaviors by informal caregivers of older adults: an integrative review

Brito, Cleidiane Maria Sales de; Figueiredo, Maria do Livramento Fortes; Tyrrell, Maria Antonieta Rubio

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Acta Paulista de Enfermagem

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Sumário

Review Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AR03783 copy

Health promoting behaviors by informal caregivers of older adults: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the scientific evidence on health promoting behaviors adopted by informal caregivers of older adults.

Methods

This is an integrative review carried out on the following bases: Online Medical Literature Analysis and Retrieval System, SCOPUS, Web of Science, Health Sciences Bibliographic Index, Nursing Database and Latin American and Caribbean Health Sciences Literature. Twelve primary studies were surveyed that constituted the sample, without time or language limitations. The descriptive method was used for analysis and synthesis of results.

Results

Health promoting behaviors developed by informal caregivers of older adults constituted resources favorable to the maintenance of their overall health conditions, their well-being, the improvement of quality of life and personal satisfaction as a caregiver. Among the practices evidenced, the search for information, family counseling, support and social, emotional and spiritual support stood out. Also, compliance with community programs aimed at psychoeducation and physical activities, as well as the use of communication technologies and the enhancement of self-care stood out as strategies associated with coping with the negative repercussions resulting from care.

Conclusion

Health promoting behaviors capable of favoring quality of life and physical, mental and social well-being of informal caregivers of older adults were evidenced. Studies of this nature may arouse the need for public policies and comprehensive lines of care aimed at promoting caregivers’ health.

Aged; Caregivers; Behavior; Health promotion

Health Sciences Descriptors
P	Controlled	Cuidadores; Older adults.
P	Uncontrolled	Cônjuges Cuidadores; Cuidador; Cuidador de Família; Cuidador Familiar; Cuidadores Cônjuges; Cuidadores de Família; Cuidadores Familiares; Familiar Cuidador; Familiares Cuidadores; Caregivers; Cuidadores; Older adults; Pessoa de Idade; Pessoa Idosa; Pessoas de Idade; Pessoas Idosas; População Idosa; Aged; Anciano.
I	Controlled	Comportamento
I	Uncontrolled	Conduta; Behavior; Conducta.
Co	Controlled	Promoção da Saúde
Co	Uncontrolled	Promoção do Bem Estar; Promoção em Saúde; Health Promotion; Promoción de la Salud.
Medical Subject Headings
P	Controlled	Caregivers; Aged.
P	Uncontrolled	Caregiver; Carers; Carer; Care Givers; Care Giver; Spouse Caregivers; Spouse Caregiver; Family Caregivers; Family Caregiver; Elderly.
I	Controlled	Behavior.
I	Uncontrolled	Behaviors; Acceptance Processes; Acceptance Process.
Co	Controlled	Health Promotion.
Co	Uncontrolled	Promotion of Health; Health Promotions.
P AND I AND Co
(((((((((((((“Caregivers”[Mesh]) OR (“caregivers”[All Fields])) OR (“caregiver”[All Fields])) OR (“carers”[All Fields])) OR (“carer”[All Fields])) OR (“care givers”[All Fields])) OR (“care giver”[All Fields])) OR (“spouse caregivers”[All Fields])) OR (“spouse caregiver”[All Fields])) OR (“family caregivers”[All Fields])) OR (“family caregiver”[All Fields])) AND (((“Aged”[Mesh]) OR (“aged”[All Fields])) OR (“elderly”[All Fields]))) AND ((((“Behavior”[Mesh]) OR (“behavior”[All Fields])) OR (“acceptance processes”[All Fields])) OR (“acceptance process”[All Fields]))) AND ((((“Health Promotion”[Mesh]) OR (“health promotion”[All Fields])) OR (“promotion of health”[All Fields])) OR (“health promotions”[All Fields]))

Author and journal	Title	Year	Country	Design	LoE
Bjørge H⁽¹⁹⁾ BMC Health Serv Res	The effect of psychosocial support on caregivers’ perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial	2019	Norway	Randomized clinical trial (RCT)	1B
Paul C⁽²⁰⁾ Community Mental Health Journal	Effects of a community intervention program for dementia on mental health: the importance of secondary caregivers in promoting positive aspects and reducing strain	2019	Portugal	Clinical trial	1B
Clauss E⁽²¹⁾ J Occup Health Psychol	Promoting personal resources and reducing exhaustion through positive work reflection among caregivers	2018	Germany	Clinical trial	1B
Lok N⁽²²⁾ Arch Gerontol Geriatr	Pilot testing of the “First You Should Get Stronger” program among caregivers of older adults with dementia	2017	Turkey	Clinical trial	1B
Kaufman AV⁽²³⁾ J Gerontol Soc Work	Social support, caregiver burden, and life satisfaction in a sample of rural African American and White caregivers of older persons with dementia	2010	USA	Cross-sectional	2C
Lewis SL⁽²⁴⁾ Rehabil Nurs	A stress-busting program for family caregivers	2009	Spain	Clinical trial	1B
Lee CJ⁽²⁵⁾ J Gerontol Nurs	A comparison of health promotion behaviors in rural and urban community-dwelling spousal caregivers	2009	Portugal	Observational	2C
Torp S⁽²⁶⁾ Health Soc Care Community	A pilot study of how information and communication technology may contribute to health promotion among elderly spousal carers in Norway	2008	Norway	Intervention	1B
Furlong KE⁽²⁷⁾ Qual Health Res	Self-Care behaviors of spouses caring for significant others with alzheimer’s disease: The emergence of self-care worthiness as a salient condition	2008	Canada	Observational Grounded theory	2C
Mittelman MS⁽²⁸⁾ Am J Geriatr Psychiatry	Preserving health of alzheimer caregivers: Impact of a spouse caregiver intervention	2007	USA	RCT	1B
O’Connell B⁽²⁹⁾ Aust Health Ver	Promoting the health and well being of older carers: a proactive strategy	2003	Australia	Descriptive	2C
Farran CJ⁽³⁰⁾ J Gerontol Nurs	Caring for self while caring for others: the two-track life of coping with Alzheimer’s disease	2004	USA	Intervention	1B

Health promoting behaviors	Main results and conclusions
Participation in education activities about the health status of older adults and group meetings, as well as family counseling.⁽¹⁹⁾	Improved perception of health status, mental well-being and quality of life. Furthermore, there was a better relationship between caregiver and recipient.
Participation in psychoeducational community intervention.⁽²⁰⁾	Improved mental health, increased satisfaction with care, and decreased tension and stress. These results were associated with the existence of a secondary caregiver, the number of hours of care and the level of dependence of older adults.
Daily reflection of care activities.⁽²¹⁾	Reduction of emotional exhaustion and fatigue indicators as well as promoting well-being.
Search for psychoeducational activities “First you must get stronger.”⁽²²⁾	Reducing the burden of care and developing healthy lifestyle behaviors, such as the pursuit of physical activity, better eating habits, weight control, interpersonal communication, moral development and stress management.
Strengthening of support networks and social support.⁽²³⁾	Dimensions of social support aimed at socialization and receiving positive feelings, respect and self-esteem were predictors of satisfaction with life and with the demand for care, directly resulting in a reduction in burden levels.
Compliance with a stress-reduction program based on education, stress management, problem solving, and support.⁽²⁴⁾	Demonstrated improvements in the ability to deal with care stressors effectively, resulting in self-control, greater ability to manage patients’ needs and better quality of personal life.
Strengthening of interpersonal relationships, spiritual growth and stress control and physical activity.⁽²⁵⁾	Appreciation of interpersonal relationships (talking and sharing experiences) and spiritual growth (reflection and prayer) positively influenced the maintenance of physical health and the control of stressful events
Use of information and communication technology (ICT) to seek informal support.⁽²⁶⁾	Despite revealing a significant reduction in stress or mental health problems, health promoting effects were found, allowing greater control of perceived health due to the possibilities of support and contact with other caregivers who experience similar experiences.
Search for relational (emotional assistance) and instrumental (physical assistance) support, as well as for valuing and showing interest in self-care (physical activity, specialized consultations, participation in support group meetings.⁽²⁷⁾	Improvement in well-being.
Support and advice on caregivers’ health condition. ⁽²⁸⁾	Benefits were evidenced related to the reduction of stress and depressive symptoms, better satisfaction with the role of caregiver and social support.
Participation in social and health activities, compliance with physical activity (Walking) and eating with friends were the most mentioned activities.⁽²⁹⁾	Well-being and quality of life promotion. Factors related to dependence on care, the inability to leave older adults alone, physical and mental exhaustion made it difficult to comply with health promoting behaviors.
Development of mental health maintenance skills.⁽³⁰⁾	Reduction of depressive symptoms

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author: Cleidiane Maria Sales de Brito Email: cleideenf@hotmail.com