de Vugt Marjolein E, Stevens Fred, Aalten Pauline, Lousberg Richel, Jaspers Niek, Winkens Ieke, Jolles Jellemer, Verhey Frans R J
Department of Psychiatry and Neuropsychology, University of Maastricht, The Netherlands.
Int J Geriatr Psychiatry. 2004 Jan;19(1):85-92. doi: 10.1002/gps.1044.
Little is known about the effectiveness of caregiver management strategies on the functioning of the demented patient. However, identification of specific caregiver strategies may provide useful information on the management and manifestation of behavioural problems in dementia.
Ninety-nine patients with dementia and their informal caregivers were followed up for one year. Interviews were used to assess differences in caregiver management strategies. Behavioural disturbances in the patient were measured with the Neuropsychiatric Inventory (NPI). Repeated measures analysis were carried out to investigate the relationship between caregiver management strategies and patient behaviour.
Three caregiver management strategies were identified, based on whether caregivers accepted, or not, the caregiving situation and dementia related problems. Caregivers characterized by non-acceptance were typified as 'Non-adapters'; caregivers characterized by acceptance were further subdivided into two groups typified as 'Nurturers' and 'Supporters'. Caregiver characteristics such as sex, education and personality were important determinants of management strategies. MANOVA showed that non-adapters reported significantly more hyperactivity symptoms in patients and felt less competent than did supporters.
Caregiver management strategies would appear to be associated with behavioural problems in dementia, and are important in predicting patient behaviour and caregiver burden. Intervention programmes should aim at teaching caregivers adequate management strategies.
关于照护者管理策略对痴呆患者功能的有效性，人们了解甚少。然而，识别特定的照护者策略可能为痴呆行为问题的管理和表现提供有用信息。
对99名痴呆患者及其非正式照护者进行了为期一年的随访。通过访谈评估照护者管理策略的差异。使用神经精神科问卷（NPI）测量患者的行为障碍。采用重复测量分析来研究照护者管理策略与患者行为之间的关系。
根据照护者是否接受照护情况和与痴呆相关的问题，确定了三种照护者管理策略。以不接受为特征的照护者被归类为“不适应者”；以接受为特征的照护者进一步细分为两组，分别为“培育者”和“支持者”。照护者的特征，如性别、教育程度和性格，是管理策略的重要决定因素。多变量方差分析表明，与支持者相比，不适应者报告患者的多动症状明显更多，且感觉自己能力更差。
照护者管理策略似乎与痴呆患者的行为问题有关，对预测患者行为和照护者负担很重要。干预项目应旨在教导照护者适当的管理策略。
