Rudd M G, Viney L L, Preston C A
Department of Psychology, University of Wollongong, NSW, Australia.
Int J Aging Hum Dev. 1999;48(3):217-40. doi: 10.2190/MGMP-31RQ-9N8M-2AR3.
A comparison of the grief responses of spousal caregivers who cared for their demented partners at home with those who provided ongoing nursing home care, together with an examination of gender differences, is reported here. Four psychological states of grief were examined: anxiety, sadness, anger, and guilt. Sixty spousal caregivers participated in the study: thirty husbands and thirty wives, with equal numbers of home and nursing home caregivers. Content analysis scales were scored to assess the four psychological states. A self-rating, adjective mood scale was also used as a secondary measure of those states. A personal construct model of spousal caregivers' bereavement for their demented partners was developed and provided the two hypotheses about differences in grieving. As predicted, nursing home caregivers expressed significantly higher levels of sadness and guilt than home caregivers. Against prediction, home caregivers expressed significantly more anger than nursing home caregivers. Home caregiving wives were found to be the most angry cohort. Also, as predicted, caregiving wives expressed significantly higher levels of anxiety, sadness, and anger than caregiving husbands. The results of the content analysis scales were confirmed by the secondary measure, but the former measure proved more powerful for detecting statistically significant differences. The inclusion of severity of the patients' dementia, and the spiritually and age of the spousal caregivers as covariates in the statistical analyses showed place of care and gender of caregiver to remain the most powerful predictors of the four psychological states of grief.
本文报告了对在家照顾痴呆伴侣的配偶照顾者与提供持续养老院护理的配偶照顾者的悲伤反应进行的比较，并对性别差异进行了研究。研究考察了悲伤的四种心理状态：焦虑、悲伤、愤怒和内疚。60名配偶照顾者参与了研究，其中包括30名丈夫和30名妻子，家庭照顾者和养老院照顾者人数相等。对内容分析量表进行评分以评估这四种心理状态。还使用了自评形容词情绪量表作为这些状态的辅助测量方法。构建了配偶照顾者对其痴呆伴侣丧亲之痛的个人建构模型，并提出了关于悲伤差异的两个假设。正如预测的那样，养老院照顾者表现出的悲伤和内疚程度明显高于家庭照顾者。与预测相反，家庭照顾者表现出的愤怒明显多于养老院照顾者。发现家庭照顾的妻子是最愤怒的群体。此外，正如预测的那样，照顾妻子表现出的焦虑、悲伤和愤怒程度明显高于照顾丈夫。内容分析量表的结果得到了辅助测量方法的确证，但前者在检测统计学上的显著差异方面更具效力。在统计分析中纳入患者痴呆的严重程度以及配偶照顾者的精神状态和年龄作为协变量后，护理地点和照顾者性别仍然是悲伤四种心理状态最有力的预测因素。
