Gaugler Joseph E, Mittelman Mary S, Hepburn Kenneth, Newcomer Robert
Center on Aging, School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA.
Psychol Aging. 2009 Jun;24(2):385-96. doi: 10.1037/a0016052.
Prior research has yielded discrepant findings regarding change in caregiver burden or depressive symptoms after institutionalization of persons with dementia. However, earlier studies often included small postplacement samples. In samples of 1,610 and 1,116 dementia caregivers with up to 6 months' and 12 months' postplacement data, respectively, this study identified predictors of change in caregiver burden and depressive symptoms following nursing home admission. Descriptive analyses found that caregivers reported significant and considerable decreases in burden in the 6- and 12-month postplacement panels. A number of variables predicted increased burden and depressive symptoms in the 6- and 12-month postplacement panels. Preplacement measures of burden and depressive symptoms, site (Florida), overnight hospital use, and spousal relationship appear to result in impaired caregiver well-being following nursing home admission. Incorporating more specific measures of stress, considering the influence of health-related transitions, and coordinating clinical strategies that balance caregivers' needs for placement with sustainability of at-home care are important challenges for future research.
先前的研究在痴呆症患者机构化后照顾者负担或抑郁症状的变化方面得出了不一致的结果。然而，早期研究通常纳入的安置后样本较小。在分别有多达6个月和12个月安置后数据的1610名和1116名痴呆症照顾者样本中，本研究确定了养老院入院后照顾者负担和抑郁症状变化的预测因素。描述性分析发现，照顾者报告在安置后6个月和12个月时负担显著且大幅减轻。一些变量预测了安置后6个月和12个月时负担和抑郁症状的增加。安置前的负担和抑郁症状测量、地点（佛罗里达州）、过夜住院情况以及配偶关系似乎会导致养老院入院后照顾者的幸福感受损。纳入更具体的压力测量指标、考虑与健康相关转变的影响以及协调平衡照顾者安置需求与居家护理可持续性的临床策略是未来研究面临的重要挑战。
