Robinson K M, Adkisson P, Weinrich S
School of Nursing, University of Louisville, Louisville, Kentucky 40292, USA.
J Adv Nurs. 2001 Nov;36(4):573-82. doi: 10.1046/j.1365-2648.2001.02010.x.
Problem behaviours that occur during Alzheimer's disease (AD) can have major impact on caregivers. How caregivers react to these behaviours may determine the total impact experienced from caregiving.
This study examined the relationships between problematic behaviours and caregiving impact in 30 primary caregivers of persons with AD. The first question explored the relationship between frequency of problem behaviour and impact; the second explored the relationship between caregiver reactions to problem behaviours and impact from caregiving.
The frequency of problem behaviour and the caregiver reaction was measured using The Revised Memory and Behaviour Problem Checklist (Teri et al. 1992). The impact from caregiving was operationalized using the Cost of Care Index developed by Kosberg and Cairl (1986).
Significant associations were found for 11 of the 20 subscales that measured the association between the frequency of problem behaviour in the client and the impact from caregiving experienced by the caregiver. In comparison, the association between caregiver's reaction to problem behaviours and impact from caregiving was even more significant in value with 15 subscales of 20 being significant. Female caregivers experienced a greater reaction to disruptive and depressive behaviour when compared with male caregivers even though both genders reported similar frequencies of problem behaviours. In regard to findings about the impact from caregiving, four of the six indicators were higher for women than for men.
Caregiver reaction to problem behaviours was more highly associated with impact from caregiving than the actual frequency of the behaviours. These findings have great implications for intervention programs. Caregivers, especially females, need to receive individualized, specific education/training on how to understand and manage disruptive and depressive behaviour in persons with AD.
阿尔茨海默病(AD)期间出现的问题行为会对照料者产生重大影响。照料者对这些行为的反应可能决定照料所带来的总体影响。
本研究调查了30名AD患者的主要照料者中问题行为与照料影响之间的关系。第一个问题探讨了问题行为频率与影响之间的关系;第二个问题探讨了照料者对问题行为的反应与照料影响之间的关系。
使用修订后的记忆与行为问题清单(特里等人,1992年)测量问题行为的频率和照料者的反应。使用科斯伯格和卡尔(1986年)开发的照料成本指数来衡量照料的影响。
在测量患者问题行为频率与照料者所经历的照料影响之间关联的20个分量表中,有11个发现了显著关联。相比之下,照料者对问题行为的反应与照料影响之间的关联在数值上甚至更显著,20个分量表中有15个显著。与男性照料者相比,女性照料者对破坏性行为和抑郁行为的反应更大,尽管两性报告的问题行为频率相似。关于照料影响的研究结果,六个指标中有四个女性高于男性。
照料者对问题行为的反应与照料影响的关联比行为的实际频率更高。这些发现对干预项目具有重要意义。照料者,尤其是女性,需要接受关于如何理解和管理AD患者的破坏性行为和抑郁行为的个性化、具体的教育/培训。