Our survey of more than 700 caregivers across Europe and Canada highlights the tremendous and too often hidden value of caregiving. In short informal carers are fundamental to the functioning of any health and social care system; it is critical to therefore to invest in measures to support these caregivers and identify potential risk factors that might lead to a breakdown in caregiving support.

To identify the importance of family care in the context of modern community mental health services.

Survey questionaire and interview of family members. A survey was developed in consultation with EUFAMI.

The average length of the caring week exceeds the length of the working week On average informal carers provide more than 43 hours of care every week, well in excess of the average working week.

Family care needs to be recognised as a significant part of the overall care package in differenct countries. Govenments need to acknowledge the real cost of care. In our report we have highlighted that the average caring week is much longer than the working week, and that this is over 60 hours per week for carers who live with the person that the care for. We have highlighted major detrimental effects on carer quality of life, as well as high levels of loneliness. We have also noted that more than a quarter of all carers have a depression or anxiety disorder. We have seen wider adverse impacts on potential career and education prospects as well as financial worries.

This survey and report were possible thanks to the sponsorship of Ferrer Internacional S.A, Janssen Pharmaceutica NV, Lundbeck A/S and Otsuka Pharmaceutical Europe Ltd. The sponsors did not have any influence over the content

In mental health nursing, the therapeutic relationship is central to the care process, since the restoration of the balance of the person in mental suffering relies on significant interpersonal relationships.

This scoping review aims to map which personal qualities of the nurse favor the therapeutic relationship in mental health nursing.

A question was formulated according to the PICo method: What are the nurse’s personal qualities that benefit the therapeutic relationship with the patient in mental health settings? For the selection of studies were used the following databases: Cochrane Database of Systematic Reviews; CINAHL; MEDLINE. A survey was carried out, with the following Boolean conjugation (nurse AND patient) and (personal AND qualities) and (mental AND health) and (therapeutic relation OR relation*). The limit applied to this research was the full text.

A total of 12 studies were analyzed. These are predominantly qualitative with different methodological approaches. The nurse’s personal attributes or qualities imply not making judgments, be patient, be open and genuine. It was also evidenced the importance of the professional and personal dimensions in the therapeutic relationship.

In all studies, it was clear that the therapeutic relationship is influenced by attributes of the professional dimension that are linked, mainly, with the theoretical domain, technical knowledge and by attributes of the personal dimension that are related with the professional’s personal qualities or characteristics. The strategies used for the development of the therapeutic relationship imply the involvement of the person nurse, using this to elements of the personal and social sphere.

No significant relationships.

To confirm the factor validity of the Compassionate Engagement and Action Scales (CEAS), as set out in the original development study, when used with a sample of family carers of older adults.

A series of confirmatory factor analyses were undertaken to test the previously proposed factor solutions of each scale.

As part of a larger cross-sectional survey, the scales were completed online or via hard copy between July and December 2019.

An international sample of 171 family carers of adults aged 65 years or older.

The CEAS are three measures that individually assess Compassion for Self, Compassion to Others, and Compassion from Others. All scales measure two aspects, “engagement” and “actions” (two-factor solution), and Compassion for Self also measures two further dimensions within engagement: “sensitivity to suffering” and “engagement with suffering” (three-factor solution).

Results were largely consistent with the two-factor solutions proposed for the three orientations of compassion, with acceptable fit and good internal reliability. There was some support for the three-factor solution of Compassion for Self; however, despite model fit comparable to the two-factor solution, internal reliability of the delineated “engagement” dimensions was low, and there was a weak factor loading for item 5 that measured distress tolerance.

Use of the CEAS with family carers of older adults is promising. Further research is recommended with larger samples and to explore distress tolerance as a competency within conceptualization and measurement of compassion.

Population aging places greater demands on the supply of informal carers. The aims of this study were to examine (1) the types of unmet support needs of carers of older Australians and (2) the association of unmet needs with mental health.

Utilizing new data from the 2015 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers, we calculated the prevalence of carers experiencing specific and multiple unmet needs for support, using single and multiple item measures. Logistic regression models were fitted to examine the association between unmet needs and psychological distress (using the Kessler psychological distress scale), once demographic and health factors were controlled for.

In 2015, 35% of carers of older Australians cited at least one unmet need for support. Among this group, almost two-thirds cited multiple unmet support needs (64.7%). The most prevalent types of unmet needs included financial (18%), physical (13%), and emotional support (12%), as well as additional respite care and support to improve carer health (12%). After controlling for demographic and health characteristics of the carer, having any unmet need for support increased the odds of psychological distress by twofold (OR = 2.20, 95% CI = 1.65, 2.94). With each successive unmet need for support, the odds of psychological distress increased 1.37 times (OR = 1.36, 95% CI = 1.22, 1.54). Those who had received assistance with care, but required further support were 1.95 times more likely (OR = 1.95, 95% CI = 1.17, 3.24) to be in distress and those who had not received care assistance were about 2.4 times more likely (OR = 2.38 95% OR = 1.56, 3.62) to be in distress relative to those with no unmet need.

Addressing unmet support needs of carers is important, not only for the planning of services for carers in an aging population, but also because of the association between unmet support needs and carers mental health.

Despite well-documented evidence of the psychological effects of caring for a relative with dementia, little is known about the bereavement experiences of family carers. The aim of this study was to explore the key psychological changes associated with carers’ adjustment to bereavement and “life after care.”

All carers taking part were recruited from a day care center, providing specialist services to people with dementia. We asked carers to describe the key changes associated with psychological adjustment to bereavement through semi-structured qualitative in-depth interviews. Strategies carers used to cope with and adapt to their new role were also explored. All data were thematically analysed.

Thirty-one carers were interviewed. The most frequent emotional reactions to bereavement were feelings of loneliness, loss, void, sadness, anger, and relief. Most carers were able to adapt to their new role, and engaging in pleasant activities was the most frequent strategy used to cope with loss and “life after care.”

Feelings of loneliness and loss are amongst the key emotional reactions shaping carers’ adjustment to bereavement. Most carers are able to adapt to loss; however, a minority experience increased psychological distress after the death of their loved one. A small percentage of carers continues caring for other dependants. Further research is required to identify how carers of people with dementia adapt to bereavement and how this increasing number of individuals can be best supported.

When infants are at risk of being born at a very premature gestation (22–25 weeks), parents face important life-support decisions because of the high mortality for such infants. Concurrently, providers are challenged with providing parents a supportive environment within which to make these decisions. Practice guidelines for medical care of these infants and the principles of perinatal palliative care for families can be resources for providers, but there is limited research to bridge these medical and humanistic approaches to infant and family care. The purpose of this article is to describe how parents at risk of delivering their infant prior to 26 weeks gestation interpreted the quality of their interpersonal interactions with healthcare providers.

Directed content analysis was employed to perform secondary analysis of data from 54 parents (40 mothers and 14 fathers) from the previously coded theme “Quality of Interactions.” These categorized data described parents' encounters, expectations, and experiences of interactions that occurred prenatally with care providers. For this analysis, Swanson's theory of caring was selected to guide analysis and to delineate parents' descriptions of caring and uncaring interactions.

Parents' expectations for caring included: (a) respecting parents and believing in their capacity to make the best decisions for their family (maintaining belief); (b) understanding parents' experiences and their continued need to protect their infant (knowing); (c) physically and emotionally engaging with the parents (being with); (d) providing unbiased information describing all possibilities (enabling); and (e) helping parents navigate the system and creating a therapeutic environment for them in which to make decisions (doing for).

Understanding parents' prenatal caring expectations through Swanson's theory gives deeper insights, aligning their expectations with the palliative care movement.