Background
Good glucose control is an indicator of treatment adherence and insulin therapy. However, insulin rejection has become an increasingly concerning phenomenon and is underdiscussed in health modules. The effects of incomplete exploration and suboptimal analysis requirements have led to the problem of insulin rejection, which needs to be identified by considering the broader perceptions of informal caregivers and patients with type 2 diabetes mellitus. Photo-elicitation, a technique that combines images and interviews, has gained traction for in-depth exploration. This study aimed to explore insulin rejection using photo-elicitation in this population.
Methods
This study employed a qualitative phenomenological design. The photo-elicitation interview involved ten photographs, which were taken and discussed narratively. This involved 10 families of informal caregivers and patients with type 2 diabetes mellitus between 20 and 60 years of age as purposive sampling at the Hospital Sultanah Nur Zahirah, Kuala Terengganu. Glycated hemoglobin levels (%) were between 6.3% and 14.8% in patients with type 2 diabetes mellitus. Atlas.ti version 25 and an Excel spreadsheet were used to analyze qualitative data through thematic analysis based on Maslow’s hierarchy of needs.
Results
Four main themes were revealed: (1) financial challenges, (2) public stigma related to insulin therapy, (3) improving self-efficacy for self-action, and (4) improving glycemic levels for quality of life.
Conclusion
Photo-elicitation successfully explored trends in the management of type 2 diabetes mellitus in this population. This study provides insights into the use of needs analyses to create more engaging experiences when designing comprehensive evidence- and need-based interventions.

Background
Family caregivers should focus on maintaining independence when assisting older adults with mobility. This may, however, bring about a counterproductive effect, namely Informal Caregiver-induced Forced Immobility (ICFI). This study explored the perceptions and experiences of older adults and their informal caregivers regarding ICFI.
Methods
This qualitative study used a conventional content analysis approach and was conducted from January to September 2023 in Tabriz, Iran. Twenty older adults (aged 60 years and above) who had used a mobility aid, such as a cane or walker, and 14 informal caregivers were purposefully (purposive sampling) selected to participate in the study. Individual semi-structured interviews were conducted until data saturation was achieved. MAXQDA ver. 20.0 software (VERBI Software, Germany) was used to manage and analyze the data.
Results
Based on the participants’ perceptions, ICFI means that for an older adult, “social interaction/social participation is limited,” “performing activities of daily living is disallowed,” and “engaging in physical activities and exercising is prohibited.”
Conclusion
Our findings revealed the concept of ICFI from various perspectives in Iranian families with older adults, leading to a clearer understanding of this phenomenon. This aspect should be considered when developing intervention strategies for the care of older adults in home and residential care settings by, health practitioners, gerontologists, and policymakers. This research can serve as a foundation for future studies to develop pertinent indicators and tools for measuring ICFI in the hope of providing sufficient evidence to support interventions that aim to prevent or stop ICFI.

Citations

• "Predisposing factor of informal caregiver-induced forced immobility in community-dwelling frail older adults: A qualitative study"
  Parvaneh Ghahremaninasab, Haidar Nadrian, Parvin Sarbakhsh, Fatemeh Zarghami
  Geriatric Nursing.2025; 65: 103515.     CrossRef

Background
This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals.
Methods
An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes.
Results
Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral.
Conclusion
The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Background
Family function is a necessary factor that influences older people’s health. The Family APGAR has been widely used to study family functions. However, there has been no Persian version of this instrument to assess family function in older people. The aim of this study was to determine the psychometric properties of the Persian version of the Family APGAR Scale to evaluate the perception of family functions.
Methods
The “forward-backward” procedure was applied to translate the scale from English into Persian. The translated version was checked in terms of validity and reliability, with a sample of 281 older people selected from retirement centers. The factor structure of the scale was also tested using a confirmatory factor analysis. To test reliability, internal consistency and test–retest analyses were performed.
Results
The results of the confirmatory factor analysis indicated a good structural model. Criterion-related validity was strongly supported by the pattern of association between the APGAR Scale and the social support survey. Cronbach’s α of the scale was 0.88 and test–retest reliability ranged from 0.96 to 0.98, indicating a good range of reliability.
Conclusion
The findings of this study suggest that the Iranian version of the Family APGAR is a valid and reliable scale to evaluate family functions in health intervention programs.

Citations

• Advance care planning readiness among older adults in aged service centers: A cross-sectional study
  Kalok Wong, Haobin Yuan, Stephen Tee, Sinkei Cheong
  International Journal of Nursing Sciences.2025; 12(1): 59.     CrossRef
• Psychosocial distress in people with overweight and obesity: the role of weight stigma and social support
  Vladimira Timkova, Pavol Mikula, Iveta Nagyova
  Frontiers in Psychology.2025;[Epub]     CrossRef
• ‘Let the System Do Its Job and Families Handle the Rest’? Protective and Risk Factors Contributing to Pandemic Crisis Parental Burnout
  Roman Ryszard Szałachowski, Wioletta Tuszyńska-Bogucka, Jacek Bogucki
  Journal of Clinical Medicine.2025; 14(2): 617.     CrossRef
• Homogeneity, dimensionality, convergent and nomological validity of the family APGAR among primary care users in Bucaramanga, Colombia
  Julián Andrés Jaimes-Grimaldos, Carlos Arturo Cassiani-Miranda, Andrés Felipe Tirado-Otálvaro, German Díaz Buitrago, Adalberto Campo-Arias, Sandra Milena Velásquez-Vergara, Andrea Carolina Duran-Bedoya
  Journal of Family Social Work.2025; 28(2): 72.     CrossRef
• Prevalence of suicidal ideation, depression, and family dysfunction in first-year students of the Bachelor’s Degree in Medical Surgery at the Universidad Regional del Sureste
  Brenda Lucila Reymundo-Sánchez, Diana Matías-Pérez, César Alejandro Mendoza-García, Iván Antonio García-Montalvo
  Frontiers in Education.2025;[Epub]     CrossRef
• Medication adherence and its determinants among non-communicable disease patients in rural area of Bihar, India: Insights for improving treatment outcomes
  Shibajee Debbarma, Akanksha Yadav, Bijaya Nanda Naik, Sanjay Pandey, Mohit Bhardwaj, Sarita Kumari, Rangnath Singh, Ratnadeep Biswas
  Journal of Family Medicine and Primary Care.2025; 14(8): 3338.     CrossRef
• Risk factors and a nomogram for predicting cognitive frailty in Chinese patients with lung cancer receiving drug therapy: A single‐center cross‐sectional study
  Jinping Li, Yan Wang, Minfeng Zhai, Mengyuan Qin, Dandi Zhao, Qian Xiang, Zaoyuan Shao, Panrong Wang, Yan Lin, Yiting Dong, Yan Liu
  Thoracic Cancer.2024; 15(11): 884.     CrossRef
• Psychometric adequacy of the persian adapted version of the tilburg frailty indicator (P-TFI)
  Maryam Safarnavadeh, Leili Salehi
  BMC Geriatrics.2024;[Epub]     CrossRef
• Risk Factors Associated with Suicidal Ideation in Students of the Faculty of Medicine and Surgery, URSE
  Iván Antonio García-Montalvo, Diana Matías-Pérez, Silvia Lois López-Castellanos, Enrique López-Ramírez, Moisés Martínez-López
  Psychiatry International.2024; 5(3): 544.     CrossRef
• Relación de la capacidad funcional y la funcionalidad familiar con la fragilidad en adultos mayores con riesgo cardiovascular en el suroccidente colombiano
  Clara Inés Paz , Betsy Mercedes Ledezma , Diana María Rivera, Mabel Lorena Salazar , María Verónica Torres , Franklin René Patiño, Andry Yasmid Mera-Mamián
  Biomédica.2024; 44(4): 537.     CrossRef
• Estrés en gestantes migrantes y función familiar durante la COVID-19 en el Norte de Santander, Colombia
  Amanda Rodríguez-López, Andrés Daniel Gallego-Ardila, Olga María Garzón-Rubio, Angy Lorena Rivera-Rodríguez, David Andrade-Fonseca
  Hacia la Promoción de la Salud.2024; 29(3): 55.     CrossRef
• Identifikasi Disfungsi Keluarga pada Lansia yang Tinggal Bersama Keluarga dengan Pengkajian APGAR Keluarga
  Nida Ashifa Rahmadi, Yenny Okvitasari, Salsabila Salsabila, Nor Halimah, Rabiatul Zinan
  Jurnal Pengabdian Kesehatan Komunitas.2024; 3(3): 11.     CrossRef
• Analysis of the Functioning of Families of Children with Autism Spectrum Disorder: A Psychometric Study of the Family APGAR Scale
  Laura Serrano, Esther Vela, Laura Martín
  International Journal of Environmental Research and Public Health.2023; 20(23): 7106.     CrossRef
• The family dynamics of children on the streets of Ibadan, Southwest Nigeria
  Abimbola M. Obimakinde, Moosa Shabir
  South African Family Practice.2023;[Epub]     CrossRef
• Nomogram reliability for predicting potential risk in postgraduate medical students with anxiety symptoms
  Zewen Huang, Lejun Zhang, Junyu Wang, Tingting Wang, Lu Xu, Xialing Yang, Heli Lu
  Heliyon.2022; 8(10): e10803.     CrossRef
• Riesgo familiar total y funcionalidad familiar en hogares de una agrupación familiar de San Juan de Lurigancho, 2021.
  Rocio Miriam Bravo Rojas, Cecilia Olga Martinez Ramos
  Revista Cuidado y Salud Pública.2022; 2(1): 22.     CrossRef

Background
High levels burden of long-term care of patients with schizophrenia can disrupt the functioning of family caregivers. This study evaluated a peer-assisted education method on family caregivers’ functioning of patients with schizophrenia.
Methods
In this randomized controlled trial, 64 family caregivers of schizophrenia patients in military hospitals of Tehran, Iran, were selected and randomly allocated to intervention and control groups, in 2018–2019. The peer-assisted education was performed in the experimental group for six 1-hour sessions and the family functioning was measured in both groups by the Family Assessment Device Scale. The data were analyzed by SPSS software ver. 16.0 (SPSS Inc., Chicago, IL, USA) and group differences at a level of P-value <0.05 were considered as significant.
Results
There was no significant differences between groups in the pre-intervention phase in all dimensions of family functioning (P>0.05). There were significant differences between intervention and control groups, in the post-intervention phase in mean problem-solving dimension (11.80 vs. 15.53, P=0.012) and in 2 weeks after intervention, in the dimensions of roles (21.71 vs. 23.43, P=0.015), affective involvement (19.03 vs. 21.59, P=0.017), behavior control (23.90 vs. 26.93, P=0.045), general functioning (27.15 vs. 31.40, P=0.013), and total family functioning (134.12 vs. 153.09, P=0.001).
Conclusion
The peer-assisted education significantly influenced the functioning of family caregivers of schizophrenic patients and can be recommended to improve the functioning of caregivers.

Citations

• Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review
  Olindah Silaule, Daleen Casteleijn, Fasloen Adams, Nokuthula Gloria Nkosi
  Interactive Journal of Medical Research.2024; 13: e48587.     CrossRef
• Family-based interventions versus standard care for people with schizophrenia
  Wai Tong Chien, Dennis Chak Fai Ma, Daniel Bressington, Huanyu Mou
  Cochrane Database of Systematic Reviews.2024;[Epub]     CrossRef
• Peer Support Activities for Veterans, Serving Members, and Their Families: Results of a Scoping Review
  Jean-Michel Mercier, Fardous Hosseiny, Sara Rodrigues, Anthony Friio, Suzette Brémault-Phillips, Duncan Shields, Gabrielle Dupuis
  International Journal of Environmental Research and Public Health.2023; 20(4): 3628.     CrossRef
• Effectiveness of family interventions for patients with schizophrenia: A systematic review and meta‐analysis
  Sin‐Hyang Kim, Sihyun Park
  International Journal of Mental Health Nursing.2023; 32(6): 1598.     CrossRef
• La pair-aidance pour soutenir le rétablissement en intervention précoce pour la psychose : enjeux autour de son implantation au Québec et dans la francophonie
  Paula Pires de Oliveira Padilha, Geneviève Gagné, Srividya N. Iyer, Esther Thibeault, Mary Anne Levasseur, Hélène Massicotte, Amal Abdel-Baki
  Santé mentale au Québec.2023; 48(1): 167.     CrossRef
• Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries
  Marianna Purgato, Eleonora Prina, Caterina Ceccarelli, Camilla Cadorin, Jibril O Abdulmalik, Francesco Amaddeo, Lyria Arcari, Rachel Churchill, Mark JD Jordans, Crick Lund, Davide Papola, Eleonora Uphoff, Nadja van Ginneken, Wietse Anton Tol, Corrado Barb
  Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
• Public Health Intervention for Smoking Cessation
  Soo Young Kim
  Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef

Background
Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory.
Methods
In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015–2016. Two questionnaires were used to collect the family caregivers’ characteristics, care burden, and self-efficacy, and patients’ negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention.
Results
There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05).
Conclusion
Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced.

Citations

• Health system related kidney supportive care interventions for adults with chronic kidney disease: A systematic review
  Dilantha Dharmagunawardene, Sanjeewa Kularatna, Ureni Halahakone, Louise Purtell, Ann Bonner, Helen G. Healy, Sameera Senanayake
  Journal of Renal Care.2025;[Epub]     CrossRef
• The impact of a partnership care model on self-efficacy and self-care in hemodialysis patients: A quasi-experimental study
  Khodayar Oshvandi, Hossein Moradi, Salman Khazaei, Azim Azizi
  Contemporary Clinical Trials Communications.2025; 44: 101459.     CrossRef
• Effectiveness of the Family‐Centred Empowerment Model on Informal Caregivers of People With Chronic Diseases: A Systematic Review and Meta‐Analysis
  Xiao Lin, Fei Fei, Xiaohan Zhang, Yuxin Zhou, Fang Qin, Xia Sun, Yafei Zhang, Jonathan Koffman
  Journal of Clinical Nursing.2025;[Epub]     CrossRef
• Effect of family-centered empowerment program on quality of life and caregiving burden in family caregivers of patients with hematologic malignancies: A quasi-experimental study
  Fatemeh Rashidi, Mohammad Abbasi, Hashim Hamid Shabeeb, Niloofar Ahmadi
  European Journal of Oncology Nursing.2025; 79: 102996.     CrossRef
• Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors
  Young Ju Jeong, Hee Sun Kim, Hyun Goo Kang
  CIN: Computers, Informatics, Nursing.2024; 42(1): 53.     CrossRef
• Effectiveness of family centred interventions for family caregivers: A systematic review and meta‐analysis of randomized controlled trials
  Ziqi Wang, Shuanghan Yu, Yantong Liu, Yujie Han, Wei Zhao, Wei Zhang
  Journal of Clinical Nursing.2024; 33(5): 1958.     CrossRef
• Stress management training program to address caregiver burden and perceived stress among family caregivers of patients undergoing hemodialysis: a randomized controlled trial study
  Ramisa Khouban-Shargh, Seyedmohammad Mirhosseini, Saeed Ghasempour, Mohammad Hasan Basirinezhad, Ali Abbasi
  BMC Nephrology.2024;[Epub]     CrossRef
• Telehealth applications used for self-efficacy levels of family caregivers for individuals with dementia: A systematic review and Meta-analysis
  Burcu Akpınar Söylemez, Ecem Özgül, Özlem Küçükgüçlü, Görsev Yener
  Geriatric Nursing.2023; 49: 178.     CrossRef
• The Effects of Nursing Interventions on the Level of Anxiety and Care Burden of the Caregivers of Bedridden Patients
  B Bayrak, ÇG Özkan, BC Demirbag
  Nigerian Journal of Clinical Practice.2023; 26(3): 253.     CrossRef
• Determinants Analysis Factors Affecting the Capability of Family Healthcare of Chronic Kidney Disease with Hemodialysis
  Virgianty Nur Faridah, Nursalam Nursalam, Ninuk Dian Kurniawati, Isni Lailatul Maghfiroh
  Open Access Macedonian Journal of Medical Sciences.2023; 11(G): 6.     CrossRef
• Interventions to Reduce Caregiver Burden Among Caregivers of Chronic Kidney Disease (CKD) Patients: A Scoping Review
  Sin Yee Chu, Norhayati Ibrahim, Noh Amit, Abdul Halim Abdul Gafor, Rozmi Ismail, Kai Wei Lee, Ching Sin Siau
  Sage Open.2023;[Epub]     CrossRef
• Postdischarge Caregiver Burden Among Family Caregivers of Older Trauma Patients
  Masami Tabata-Kelly, Mengyuan Ruan, Tanujit Dey, Christina Sheu, Emma Kerr, Haytham Kaafarani, Katherine A. Ornstein, Amy Kelley, Tamryn F. Gray, Ali Salim, Bellal Joseph, Zara Cooper
  JAMA Surgery.2023; 158(9): 945.     CrossRef
• Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study
  Parvaneh Vasli, Meimanat Hosseini, Malihe Nasiri, Noushin Bakhtiari
  BMC Nephrology.2023;[Epub]     CrossRef
• Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries
  Marianna Purgato, Eleonora Prina, Caterina Ceccarelli, Camilla Cadorin, Jibril O Abdulmalik, Francesco Amaddeo, Lyria Arcari, Rachel Churchill, Mark JD Jordans, Crick Lund, Davide Papola, Eleonora Uphoff, Nadja van Ginneken, Wietse Anton Tol, Corrado Barb
  Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
• Effect of teaching health-promoting behaviors on the care burden of family caregivers of hemodialysis patients: a four-group clinical trial
  Mehrdad Hayati, Razieh Bagherzadeh, Mehdi Mahmudpour, Fatemeh Heidari, Hakimeh Vahedparast
  BMC Nursing.2023;[Epub]     CrossRef
• Effectiveness of psychosocial interventions on the burden and quality of life of informal caregivers of hemodialysis patients: a systematic review
  Ana Bártolo, Helena Sousa, Oscar Ribeiro, Daniela Figueiredo
  Disability and Rehabilitation.2022; 44(26): 8176.     CrossRef
• An intervention mapping-based support program that empowers patients with endocrine therapy management
  Susanne Ahlstedt Karlsson, Ingela Henoch, Roger Olofsson Bagge, Catarina Wallengren
  Evaluation and Program Planning.2022; 92: 102071.     CrossRef
• Early Comprehensive Kidney Care in Dialysis-Requiring Acute Kidney Injury Survivors: A Populational Study
  Chun-Yi Wu, Jia-Sin Liu, Cheng-Hsu Chen, Chun-Te Huang, Tung-Min Yu, Ya-Wen Chuang, Shih-Ting Huang, Chih-Cheng Hsu, Ming-Ju Wu
  Frontiers in Medicine.2022;[Epub]     CrossRef
• The impact of family intervention programs on the caregiver burden of hemodialysis patients
  Vincencius Surani, Dewi Elizadiani Suza, Mula Tarigan
  Kontakt.2021; 23(2): 138.     CrossRef
• Interventions to improve the well-being of family caregivers of patients on hemodialysis and peritoneal dialysis: a systematic review
  Ana Carolina Hovadick, Viviane Rodrigues Jardim, Constança Paúl, Adriana Pagano, Ilka Reis, Heloisa Torres
  PeerJ.2021; 9: e11713.     CrossRef

Background
Disability not only burdens the patient, but also the caregiver. To quantify this caregiving burden, we propose a simple four-part questionnaire tool. Our objective is to validate this questionnaire by administering it to caregivers who oversee patients with low back pain and are functionally compromised.
Methods
Twenty-five spouse caregivers who were taking care of in-patients awaiting surgery for various lumbar spine pathologies were shortlisted. The content-validated questionnaire was administered on different occasions during the care recipient’s treatment. Cronbach’s α was calculated to assess internal consistency. Interrelationships between the care recipient’s pain score, extent of functional compromise, and caregiver burden were calculated. The questionnaire’s ability to track changes in the caregivers’ attitudes over time was assessed.
Results
The percentage of caregiver burden before the surgery of the care recipient was 52.5. This increased significantly to 61.1% (P=0.001) 3 days after surgery, but was found to decrease to 32.5% (P<0.001) a month after the surgery; demonstrating the questionnaire’s efficacy to track changes. Cronbach’s alpha of 0.948 signifies the questionnaire’s excellent internal consistency. Pearson’s correlation coefficient (r) between the care recipient’s pain score and caregiver’s burden score was 0.41 (P=0.04), and between the care recipient’s disability score and caregiver’s burden score was 0.9 (P<0.001).
Conclusion
The proposed questionnaire is consistent and can track changes in a caregiver’s attitude over time. It can be adopted for clinical use to assess the burden of caregiving for functionally compromised patients.

Citations

• Family functioning and caregiver's perceptions of burden among chronic kidney disease patients
  C Vasantha Kalyani, Priyanka Malhotra, Kusum Kumari
  Journal of Kidney Care.2025; 10(5): 227.     CrossRef

Citations

• Impact of family communication on self-rated health of couples who visited primary care physicians: A cross-sectional analysis of Family Cohort Study in Primary Care
  Seo Young Kang, Jung Ah Lee, Young Sik Kim, Jennifer Morozink Boylan
  PLOS ONE.2019; 14(3): e0213427.     CrossRef