title: Huntington disease: families' experiences of healthcare services.
abstract: OBJECTIVE
  This paper is a report of a study of the perceptions of family caregivers regarding the availability and adequacy of health and social care services for their family member with Huntington disease, and to compare findings from these reports in United Kingdom and United States of America samples.
  
  
  BACKGROUND
  Huntington disease is an inherited neurodegenerative condition. Family members often take responsibility for care of relatives with long-term conditions. Studies have demonstrated there are both positive and negative outcomes for carers.
  
  
  METHODS
  During 2006 and 2007, respondents from the United Kingdom (n = 108) and the United States (n = 119) who were caring for a relative affected with Huntington disease completed the Community Health Care Services Scale to identify areas of concern and the extent to which specific issues bothered carers. Data were analysed using statistical tests including chi-square, t-tests and factor analysis. Results were compared between carers in the two cohorts.
  
  
  RESULTS
  Three main factors were derived: 'community resources', 'individualized care' and 'knowledge of Huntington disease'. Carers had concerns about the knowledge of healthcare professionals providing care and thought that there were insufficient services to support them and the affected person. There were different challenges for carers when the affected person had a long-term neurodegenerative condition because these carers were also likely to have responsibilities for earning and caring for children.
  
  
  CONCLUSIONS
  Comprehensive facilities and resources are needed to support families affected by long-term complex conditions. Healthcare professionals need to be aware of the health needs of carers as well as those of the affected person.
authors.affiliation: School of Nursing and Midwifery, University of Plymouth, Taunton, UK. heather.skirton@plymouth.ac.uk
authors.forename: Heather
authors.initials: H
authors.lastname: Skirton
authors.forename: Janet K
authors.initials: JK
authors.lastname: Williams
authors.forename: J
authors.initials: J
authors.lastname: Jackson Barnette
authors.forename: Jane S
authors.initials: JS
authors.lastname: Paulsen
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D003153:Community Health Services / Q000592:standards*; D003258:Consumer Behavior; D005163:Factor Analysis, Statistical; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D006816:Huntington Disease / Q000451:nursing*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D012944:Social Support; D006113:United Kingdom; D014481:United States