Olimpia Paun

This pilot study explored the longitudinal relationship between daily dementia caregiving and physiological stress, assessed through heart rate variability (HRV) measured using a wearable device, among Korean American home care workers (HCWs). Fifteen HCWs wore the Ōura ring for 21 days, providing 14 days of valid nocturnal HRV data after baseline calibration. HRV was quantified as the root mean square of successive differences (RMSSD) derived from photoplethysmography (PPG)-based interbeat intervals. To minimize interindividual variability, HRV values were standardized within participants. Multilevel linear models examined within- and between-person associations of dementia caregiving (yes or no and total hours) with HRV, adjusting for covariates. All were women, and the majority of HCWs (86.96%) were unsure about the type of dementia their care recipients had. Of 210 potential daily observations, 198 (94.3%) were valid. HRV displayed substantial within-person day-to-day fluctuations (intraclass correlation = 0.20) despite relatively low baseline self-reported stress. Although dementia caregiving was not significantly associated with HRV, the estimated coefficients suggested small-to-moderate within-person effect sizes. These findings highlight the dynamic nature of physiological stress and underscore both the feasibility and limitations of nocturnal PPG-derived HRV for real-world stress assessment. The study provides preliminary methodological guidance for wearable-based HRV research in understudied caregiver populations.

This study evaluated the feasibility and acceptability of Ōura, a finger-worn sensor used to monitor heart rate variability (HRV) as a digital biomarker of stress among Korean-American home care workers caring for Korean-American individuals with dementia. This prospective, single-cohort study included 15 home care workers who wore Ōura for 21 days, with HRV data collected over a 14-day analysis period. Feasibility and acceptability were evaluated through quantitative and qualitative approaches. All participants were female, with a median age of 61 years, and each cared for a median of 1 Korean-American individual with dementia (range: 1 to 3 care recipients). We achieved an 88.24% retention rate and a 100% completion rate. Of the 210 potential daily HRV data points, 94.2% were valid. Participants reported high ease of use and comfort wearing the ring. Qualitative findings revealed themes of enhanced health awareness, variability in comfort and fit, and a need for more information about the health data provided by the ring application. The findings demonstrate the feasibility and acceptability of using a finger-worn sensor in Korean-American home care workers. Future studies should address data validity issues and explore the clinical utility of HRV monitoring via finger-worn sensors for stress management in this understudied population.

The mental health needs of Asian American older adults are complex and multifaceted. Despite their rich diversity, Asian American older adults face significant challenges, including mental health stigma, cultural stress, limited English proficiency, and historical trauma. In addition, the coronavirus disease 2019 pandemic reignited preexisting anti-Asian attitudes of hostility, discrimination, blame, and scapegoating. The historical context of Asian immigration to the United States, impact of race-based discrimination, and recent resurgence of anti-Asian hate crimes impact mental health in Asian American older adults. Thus, there is a need for a culturally sensitive and competent mental health care workforce, culturally tailored interventions, and family involvement. In the context of research and policy, it is critical to prioritize increased funding and research focus on culturally tailored instrument development, interventions, and policy initiatives informed by recent findings to safeguard this population from hate crimes and discrimination. [ Journal of Psychosocial Nursing and Mental Health Services, 62 (7), 11–15.]

As a universal human reaction to perceived and/or actual loss, grief is becoming increasingly pervasive at all levels of society. Among the broad spectrum of loss experiences, those associated with dementia are perhaps of the most complex. The shift toward considering loss and grief within the context of dementia caregiving is promising. However, pre-loss grief is understudied, and interventions are lacking. Only few studies have evaluated the effectiveness of pre-loss psychosocial grief interventions for dementia caregivers. Preliminary findings from an ongoing clinical trial testing the effects of an 8-week, group-based online video intervention with dementia caregivers indicate that compared to precoronavirus disease 2019 pandemic, the experience of loss and separation was exacerbated by loss of control and severe physical contact restrictions in long-term care facilities. Finding effective grief interventions that can be translated into clinical and communitybased environments is necessary to alleviate dementia caregivers' emotional distress and improve their quality of life.

We explored 10 pregnant women's experiences with antiretroviral therapy (ART) adherence using a qualitative approach. Semistructured interviews were conducted with pregnant ethnic minority women living with HIV and receiving integrated HIV/obstetric care at a Midwestern academic medical center in the United States. Data were analyzed using an interpretive phenomenology approach to identify major themes. We found an overarching theme: ART Adherence as a Balancing Act (striving to adhere to ART while having to simultaneously navigate daily challenges). We also identified four interrelated subthemes: struggles, support, motivators, and reminders. Findings highlight the need for clinicians to be sensitive to the emotional burdens of living with HIV while pregnant, a constant factor affecting quality of life and adherence. Having conversations about barriers and facilitators to adherence and encouraging women to identify strategies that support adherence are needed rather than focusing solely on pill counts and viral load.

Journal of Special Operations Medicine Featured Articles for Summer 2019. Volume 19 Issue 2.

Family caregivers of individuals with Alzheimer's disease and related dementias (ADRD) experience long-term mental health effects. Although caregivers who place relatives in long-term care (LTC) experience increased depression, anxiety, and chronic grief post-placement, interventions to improve caregivers' mental health have focused mainly on in-home care. Current researchers previously tested a group-based Chronic Grief Management Intervention (CGMI) with ADRD caregivers of individuals in LTC, with significant effects on caregiver mental health outcomes. In the current study, researchers adapted the CGMI for synchronous online video using Adobe ^® Connect ^TM and iPads ^® (Chronic Grief Management—A Live-Streaming, Online Intervention [CGMI-V]). Specific aims were to test feasibility of digital delivery of the CGMI-V and explore caregivers' online group experience. Researchers assessed participants at baseline for sociodemographic information and at the end of the program with a four-item satisfaction survey and focus group. Digital delivery of the CGMI-V was feasible and caregiver satisfaction was high. [ Journal of Psychosocial Nursing and Mental Health Services, 57 (1), 17–24.]