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      Rural unpaid caregivers' experiences in northern Aotearoa, New Zealand during the Covid‐19 pandemic: A qualitative study

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          Abstract

          Objective

          Rural unpaid caregivers experience different opportunities and challenges than their urban counterparts. Our aim was to understand rural unpaid caregivers' experiences of challenges and opportunities during the Covid‐19 pandemic in New Zealand.

          Setting

          Rural northern New Zealand during the Covid‐19 pandemic.

          Participants

          A convenience sample of 10 unpaid rural caregivers, most supporting an older person living with dementia.

          Design

          A qualitative descriptive design. Data included interviews and online workshops, and a thematic analysis.

          Results

          Rural unpaid caregivers observed that some aspects of living in a rural context were helpful during the Covid‐19 pandemic. However, tasks such as shopping and long‐distance travel and communication (both telephonic and digital) became more complex. Abrupt changes to routine and closure of resources and support groups created challenges. Unpaid caregivers worried about what would happen if they were hospitalised themselves. There was a diversity of experience both across caregivers, of familiar routines and rural context as resources, increased challenges requiring resourcefulness to adapt, and experiences of crisis. Many experienced all three states at different times.

          Conclusion

          This research provides valuable insights into challenges and opportunities experienced by rural unpaid caregivers during the Covid‐19 pandemic and may help policy‐makers and healthcare professionals develop improved emergency preparedness. Multilevel, multisector responses are needed to ensure effective health and social support and access to resources including health care, access to groceries and medication, transport, and communications (telephone and digital). Enhancing rural access to effective and inexpensive online services is particularly important, as is recognition of the value of rural sites or hubs of connection and social interaction.

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          Most cited references37

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          Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development

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              Caregiver burden: a clinical review.

              Caregiver burden may result from providing care for patients with chronic illness. It can occur in any of the 43.5 million individuals providing support to midlife and older adults. Caregiver burden is frequently overlooked by clinicians. To outline the epidemiology of caregiver burden; to provide strategies to diagnose, assess, and intervene for caregiver burden in clinical practice; and to evaluate evidence on interventions intended to avert or mitigate caregiver burden and related caregiver distress. Cohort studies examining the relation between demographic and social risk factors and adverse outcomes of caregiver burden were reviewed. Review of recent meta-analyses to summarize the effectiveness of caregiver burden interventions were identified by searching Ovid MEDLINE, AgeLine, and the Cochrane Library. Risk factors for caregiver burden include female sex, low educational attainment, residence with the care recipient, higher number of hours spent caregiving, depression, social isolation, financial stress, and lack of choice in being a caregiver. Practical assessment strategies for caregiver burden exist to evaluate caregivers, their care recipients, and the care recipient's overall caregiving needs. A variety of psychosocial and pharmacological interventions have shown mild to modest efficacy in mitigating caregiver burden and associated manifestations of caregiver distress in high-quality meta-analyses. Psychosocial interventions include support groups or psychoeducational interventions for caregivers of dementia patients (effect size, 0.09-0.23). Pharmacologic interventions include use of anticholinergics or antipsychotic medications for dementia or dementia-related behaviors in the care recipient (effect size, 0.18-0.27). Many studies showed improvements in caregiver burden-associated symptoms (eg, mood, coping, self-efficacy) even when caregiver burden itself was minimally improved. Physicians have a responsibility to recognize caregiver burden. Caregiver assessment and intervention should be tailored to the individual circumstances and contexts in which caregiver burden occurs.
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                Author and article information

                Contributors
                Journal
                Australian Journal of Rural Health
                Australian J Rural Health
                Wiley
                1038-5282
                1440-1584
                August 2024
                Affiliations
                [1 ] Faculty of Medical & Health Sciences University of Auckland Auckland New Zealand
                [2 ] Rauawaawa Kaumātua Charitable Trust Hamilton New Zealand
                [3 ] School of Management and Marketing Operations University of Waikato Hamilton New Zealand
                Article
                10.1111/ajr.13173
                effe99c0-f1aa-488f-8327-e349caa36e11
                © 2024

                http://creativecommons.org/licenses/by/4.0/

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