Yamamoto-Mitani Noriko, Ishigaki Kazuko, Kuniyoshi Midori, Kawahara-Maekawa Noriko, Hayashi Kunihiko, Hasegawa Kiyomi, Sugishita Chieko
University of California, School of Nursing, Los Angeles 90095-1702, USA.
Qual Life Res. 2004 Feb;13(1):207-21. doi: 10.1023/B:QURE.0000015296.14717.e7.
Most family caregiving research has portrayed caregiving as a negative life experience for caregivers, but a broader perspective is necessary to examine its impact on the caregiver quality of life (QL). The role that positive appraisal of care plays in the caregiving experience among Japanese families of older adults was examined in relation to the caregiver's subjective QL. Positive as well as negative appraisal of care was measured by a newly developed multi-dimensional scale, which included the domains of 'relationship satisfaction,' 'role confidence,' 'consequential gain,' 'normative fulfillment' (positive appraisal), 'role exhaustion,' 'isolation,' 'relationship difficulty,' and 'symptom management difficulty' (negative appraisal). Subjective QL was measured by WHO/QL-26. Altogether 337 Japanese family caregivers participated in this survey. Stepwise multiple regression analyses revealed that 'role confidence,' 'normative fulfillment,' and 'role exhaustion' had a significant independent impact on physical QL, while 'role confidence' and 'role exhaustion' on psychological QL. The association of 'normative fulfillment' with physical QL was negative while that of 'role confidence' was positive, despite the positive correlation between the two domains. The results underline the importance of considering positive as well as negative appraisal of care when examining subjective QL of the family caregivers.
大多数家庭照料研究都将照料描述为照料者消极的生活经历，但需要从更广泛的视角来审视其对照料者生活质量（QL）的影响。本研究考察了积极的照料评价在日本老年人家属照料经历中所起的作用，并将其与照料者的主观生活质量相关联。通过一个新开发的多维量表来衡量对照料的积极和消极评价，该量表包括“关系满意度”“角色信心”“结果收益”“规范达成”（积极评价）、“角色疲惫”“孤立感”“关系困难”和“症状管理困难”（消极评价）等维度。主观生活质量采用世界卫生组织生活质量量表简表（WHO/QL-26）进行测量。共有337名日本家庭照料者参与了本次调查。逐步多元回归分析显示，“角色信心”“规范达成”和“角色疲惫”对身体生活质量有显著的独立影响，而“角色信心”和“角色疲惫”对心理生活质量有影响。尽管“规范达成”和“角色信心”这两个维度之间呈正相关，但“规范达成”与身体生活质量的关联为负，而“角色信心”与身体生活质量的关联为正。研究结果强调了在考察家庭照料者主观生活质量时，兼顾对照料的积极和消极评价的重要性。
