Supplementary Material for: Health Economic Analysis on a Psychosocial Intervention for Family Caregivers of Persons with Dementia

<b><i>Background/Aims:</i></b> Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. <b><i>Methods:</i></b> We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). <b><i>Results:</i></b> The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). <b><i>Conclusion:</i></b> The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers

Health Economic Analysis on a Psychosocial Intervention for Family Caregivers of Persons with Dementia

Background/Aims: Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. Methods: We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). Results: The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). Conclusion: The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers. © 2013 S. Karger AG, Basel

Women and politics in democratic transitions: the case of Bhutan

This article addresses the question of what happens to women in democratic transitions. Of particular concern is whether women are encouraged to participate in politics and to stand as candidates for seats in national legislatures. In many instances, women have made only marginal progress in seeking election and getting elected in newly democratized regimes. This situation has been the experience of Bhutan, a country that held its first national elections only in 2007–2008. Despite women making significant gains in areas such as education, health and employment in Bhutan and guarantees of gender equality in the Constitution, they have made a poor showing in electoral politics. The article uses the explanatory framework of patriarchy to explore women’s minor participation in electoral politics. Of special concern are deeply rooted traditional concepts that have been employed today to exclude women from competing for and winning political office. The article concludes that because patriarchal attitudes are so deeply embedded only incremental progress will be made under current electoral rules. Alternatively, there could be quota systems as in some other South Asian countries.</p

Impact of an Individualized Physical Activity Intervention on Improving Mental Health Outcomes in Family Caregivers of Persons with Dementia: A Randomized Controlled Trial

Purpose: This study examined secondary benefits of an individualized physical activity intervention on improving dementia family caregivers’ subjective burden, depressive symptoms and positive affect. Design and Methods: A community-based randomized controlled trial (RCT) was implemented with family caregivers of persons with dementia (N = 211) who received the Enhanced Physical Activity Intervention (EPAI: treatment intervention, n = 106) or the Caregiver Skill Building Intervention (CSBI: control intervention, n = 105). Interventions were delivered over 12 months, including a baseline home visit and regularly spaced telephone calls. Data were collected in person at baseline, 6 and 12-months; and telephonically at 3 and 9-months. The EPAI integrated physical activity and caregiving content while the CSBI focused only on caregiving content. Descriptive, bivariate and intention-to-treat analyses using generalized estimating equations (GEE) were performed to examine secondary benefits of the EPAI on family caregiver burden, depressive symptoms and positive affect. Results: Compared to caregivers in the CSBI group, caregivers in the EPAI significantly increased their overall and total moderate physical activity and showed a positive interaction between the intervention and time for positive affect at both six (p = 0.01) and 12-months (p = 0.03). The EPAI was significantly associated with improving burden at 3 months (p = 0.03) but had no significant effect on depressive symptoms. Implications: Caregiver involvement in an individualized physical activity intervention was associated with increased overall and total moderate physical activity and improved positive affect from baseline to 12 months. Improved positive affect may help caregivers to feel better about themselves and their situation, and better enable them to continue providing care for their family member for a longer time at lower risk to their own mental health