Gaugler Joseph E, Kane Robert L, Kane Rosalie A, Newcomer Robert
Department of Behavioral Science, The University of Kentucky, Lexington, KY, USA.
Gerontologist. 2005 Apr;45(2):177-85. doi: 10.1093/geront/45.2.177.
The present study attempts to determine whether utilizing community-based long-term-care services early in the dementia caregiving career delays time to nursing home placement (adjusting for severity of dementia).
With a reliance on data from 4,761 dementia caregivers recruited from eight catchment areas in the United States and followed over a 3-year period, a Cox proportional hazards model was conducted that considered key components of the stress process (e.g., context of care, primary objective and subjective stressors, and resources), duration, and community-based long-term-care use.
An analysis of interaction terms in the Cox regression model found that those individuals who utilized in-home help services earlier in their dementia caregiving careers were more likely to delay institutionalization.
The findings suggest the practical importance and cost-effectiveness implications of early community-based service use, and they emphasize the role of timing when one is conceptualizing the proliferation of stress in the dementia caregiving career.
本研究旨在确定在痴呆症护理生涯早期利用基于社区的长期护理服务是否会延迟进入养老院的时间（根据痴呆症的严重程度进行调整）。
依靠从美国八个集水区招募的4761名痴呆症护理人员的数据，并对其进行了为期3年的跟踪，构建了一个考克斯比例风险模型，该模型考虑了压力过程的关键组成部分（如护理背景、主要客观和主观压力源以及资源）、持续时间和基于社区的长期护理使用情况。
考克斯回归模型中的交互项分析发现，那些在痴呆症护理生涯早期使用家庭帮助服务的人更有可能延迟机构化。
研究结果表明了早期使用基于社区服务的实际重要性和成本效益，并强调了在构思痴呆症护理生涯中压力扩散时时机的作用。
