@article{DeekenHaeuslerNordheimetal.2017,
  author    = {Deeken, Friederike and H{\"a}usler, Andreas and Nordheim, Johanna and Rapp, Michael Armin and Knoll, Nina and Rieckmann, Nina},
  title     = {Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers},
  series = {International psychogeriatrics},
  volume    = {30},
  journal   = {International psychogeriatrics},
  number    = {1},
  publisher = {Cambridge Univ. Press},
  address   = {New York},
  issn      = {1041-6102},
  doi       = {10.1017/S1041610217001387},
  pages     = {39 -- 47},
  year      = {2017},
  abstract  = {Background: The aim of the present study was to investigate the psychometric characteristics of the Perceived Stress Scale (PSS) in a sample of dementia patients and their spousal caregivers. Methods: We investigated the reliability and validity of the 14-item PSS in a sample of 80 couples, each including one spouse who had been diagnosed with mild to moderate dementia (mean age 75.55, SD = 5.85, 38.7\% female) and one spousal caregiver (mean age 73.06, SD = 6.75, 61.3\% female). We also examined the factor structure and sensitivity of the scale with regard to gender differences. Results: Exploratory factor analysis of the PSS revealed a two-factor solution for the scale; the first factor reflected general stress while the second factor consisted of items reflecting the perceived ability to cope with stressors. A confirmatory factor analysis verified that the data were a better fit for the two-factor model than a one-factor model. The two factors of the PSS showed good reliability for patients as well as for caregivers ranging between alpha = 0.73 and alpha = 0.82. Perceived stress was significantly positively correlated with depressive symptomatology in both caregivers and patients. Mean PSS scores did not significantly differ between male and female patients nor did they differ between male and female caregivers. Conclusion: The present data indicate that the PSS provides a reliable and valid measure of perceived stress in dementia patients and their caregivers.},
  language  = {en}
}
@article{GellertHaeuslerGholamietal.2017,
  author    = {Gellert, Paul and H{\"a}usler, Andreas and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna},
  title     = {Own and partners' dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners},
  series = {Aging \& Mental Health},
  volume    = {22},
  journal   = {Aging \& Mental Health},
  number    = {8},
  publisher = {Routledge, Taylor \& Francis Group},
  address   = {Abingdon},
  issn      = {1360-7863},
  doi       = {10.1080/13607863.2017.1334759},
  pages     = {1008 -- 1016},
  year      = {2017},
  abstract  = {Objectives: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between 'own DC' and 'perceived partner DC' with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels. Method: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor-partner interdependence models were applied to the resulting four independent evaluations. Results: Results differed substantially between patients and caregivers. DC was significantly related to patients' but not to caregivers' depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals. Conclusion: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole.},
  language  = {en}
}
@phdthesis{Deeken2022,
  author    = {Deeken, Friederike},
  title     = {Relevance of non-pharmacological interventions that modify environmental factors in order to prevent and treat mental disorders in older patients and their caregivers},
  school      = {Universit{\"a}t Potsdam},
  year      = {2022},
  abstract  = {We live in an aging society. The change in demographic structures poses a number of challenges, including an increase in age-associated diseases. Delirium, dementia, and depression are considered to be of particular interest in the field of aging and mental health. A common theory regarding healthy aging and mental health is that the highest satisfaction and best performance is achieved when a person's abilities match the demands of their environment. In this context, the person's environment includes both the physical and the social environment. Based on this assumption, this dissertation focuses on the investigation of non-pharmacological interventions that modify environmental factors in order to facilitate the prevention and treatment of mental disorders in older patients and their caregivers. The first part of this dissertation consists of two publications and deals with the prevention of postoperative delirium in elderly patients. The PAWEL study investigated the use of a multimodal, non-pharmacological intervention in the routine care of patients aged 70 years or older undergoing elective surgery. The intervention included an interdepartmental delirium prevention team, daily use of seven manualized "best practice" procedures, structured staff training on delirium, and the adaptation of the hospital environment to the patients' needs. The second part of the dissertation used a meta-analysis to investigate whether technology-based interventions are a suitable form of support for informal caregivers of people with dementia. Subgroup analyses were conducted to examine the effect of different types of technology on caregiver burden and depressive symptoms. The following main results were found: The PAWEL study showed that the use of a multimodal, non-pharmacological intervention resulted in a significantly lower incidence rate of postoperative delirium and reduced days with delirium in the intervention group compared to the control group. However, this difference could not be observed in the group of patients undergoing elective cardiac surgery. The results of the meta-analysis showed that technology-based interventions offer a promising alternative to traditional "face-to-face" services. Significant effect sizes could be found in relation to both the burden and the depressive symptoms of caregiving relatives. These results provide further important information on the significant impact of non-pharmacological interventions that modify environmental factors on mental health, and support the consideration of such interventions in the prevention and treatment of mental disorders in both older patients and their caregivers.},
  language  = {en}
}