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老年痴呆患者的机构化安置:照料者特征的作用。

Institutionalization of demented elderly: the role of caregiver characteristics.

作者信息

Pot A M, Deeg D J, Knipscheer C P

机构信息

Department of General Practice, Nursing Home Medicine and Social Medicine, Vrije Universiteit, Amsterdam, The Netherlands.

出版信息

Int J Geriatr Psychiatry. 2001 Mar;16(3):273-80. doi: 10.1002/gps.331.

Abstract

BACKGROUND

Three sets of caregiver characteristics were examined with respect to their explanatory value for institutionalization of demented elderly people: commitment to the caregiving relationship, psychological distress, and personality traits.

METHOD

Logistic regression was used to test whether these caregiver characteristics were risk factors for institutionalization of demented elderly people in the first year after baseline measurement (N = 138). Control variables were caregivers' sex, age and education.

RESULTS

The results showed the importance of commitment to the caregiving relationship, indicated by type of relationship between caregiver and care recipient. Demented people cared for by non-spouses were more likely to be institutionalized as compared to those cared for by spouses. For non-spouse care-givers, being more extravert increased the likelihood of institutional placement, whereas for spouse caregivers perceiving more pressure from informal increased this likelihood.

CONCLUSIONS

These findings are in agreement with the assumption that non-spouses are less strongly committed to the caregiving relationship as compared to spouses. Results were independent from elders' impairment in cognitive functioning and (Instrumental) Activities of Daily Living. Caregivers' psychopathology was not a risk factor at all, which is a matter of concern, regarding the consequences for caregivers' own health and health-care utilization, but also for their treatment of the demented elder.

摘要

背景

研究了三组照顾者特征对痴呆老年人机构化的解释价值,这些特征包括对照顾关系的投入、心理困扰和人格特质。

方法

采用逻辑回归分析来检验这些照顾者特征是否为基线测量后第一年痴呆老年人机构化的风险因素(N = 138)。控制变量包括照顾者的性别、年龄和教育程度。

结果

结果显示了照顾关系投入的重要性,这由照顾者与受照顾者之间的关系类型体现。与由配偶照顾的痴呆患者相比,由非配偶照顾的痴呆患者更有可能被送入机构。对于非配偶照顾者,性格更外向会增加机构安置的可能性,而对于配偶照顾者,感受到更多来自非正式照顾的压力会增加这种可能性。

结论

这些发现与以下假设一致,即与配偶相比,非配偶对照顾关系的投入程度较低。结果不受老年人认知功能损害和(工具性)日常生活活动能力的影响。照顾者的精神病理学根本不是一个风险因素,这一点令人担忧,因为这不仅关系到照顾者自身的健康和医疗保健利用情况,也关系到他们对痴呆老年人的照料。

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