Department of Geriatric Medicine, Alexandra Hospital, Singapore, Singapore.
Dement Geriatr Cogn Disord. 2010;29(2):115-22. doi: 10.1159/000275569. Epub 2010 Feb 11.
Caregiver gain is an important yet less-explored phenomenon. Being conceptually distinct from burden, factors associated with burden and gain can differ. This study aims to explore factors associated with the experience of gains in dementia caregiving.
Cross-sectional study involving caregivers recruited from a tertiary hospital dementia clinic and the local Alzheimer's Association. Caregivers completed a questionnaire containing the following scales: gain in Alzheimer's care Instrument (GAIN), General Health Questionnaire (GHQ-28), Dementia Management Strategies Scale (DMSS), Revised Memory and Behavioral Problems Checklist (RMBPC) and Zarit Burden Interview (ZBI). Demographic information for the person with dementia (PWD) and the caregiver was also recorded. Initial screening with univariate analyses (t tests, ANOVAs, Pearson's correlations) was performed to identify significant (p < 0.05) variables, which were then entered into a multiple regression model to identify variables associated with gain.
The final sample comprised 334 caregivers with a mean age of 51.5 years (SD = 10.9, range = 22-85), the majority of whom where Chinese (94.6%) females (71%). Mean GAIN score was 30 (SD = 6.6, range = 7-40). Regression analysis identified 3 factors significantly associated with gains (adjusted R(2) 32.3%): mental well-being of the caregiver, use of active management as a caregiving strategy, and participation in caregiver educational and support group programmes.
The results have important implications for caregiver interventions. Interventions should target maintaining mental well-being, encouraging participation in educational and support programmes, and teaching appropriate coping and dementia specific management strategies to derive good outcomes.
照料者获益是一个重要但尚未得到充分探索的现象。与负担概念上不同，与负担和获益相关的因素可能存在差异。本研究旨在探讨与痴呆症照料者获益体验相关的因素。
横断面研究，纳入对象为三级医院痴呆症诊所和当地阿尔茨海默病协会招募的照料者。照料者完成了一份包含以下量表的问卷：阿尔茨海默病照料者获益量表（GAIN）、一般健康问卷（GHQ-28）、痴呆症管理策略量表（DMSS）、修订后的记忆和行为问题清单（RMBPC）和照顾者负担访谈（ZBI）。还记录了痴呆症患者（PWD）和照料者的人口统计学信息。通过单变量分析（t 检验、方差分析、Pearson 相关分析）进行初步筛选，以确定有显著意义的变量（p < 0.05），然后将这些变量纳入多元回归模型，以确定与获益相关的变量。
最终样本包括 334 名照料者，平均年龄为 51.5 岁（SD = 10.9，范围为 22-85），其中大多数为中国人（94.6%），女性（71%）。GAIN 量表的平均得分为 30 分（SD = 6.6，范围为 7-40）。回归分析确定了与获益显著相关的 3 个因素（调整后的 R² 为 32.3%）：照料者的心理健康、采用积极的管理策略作为照护策略，以及参与照料者教育和支持小组计划。
研究结果对照料者干预具有重要意义。干预措施应针对保持心理健康、鼓励参与教育和支持计划，以及教授适当的应对和痴呆症特定管理策略，以取得良好的结果。
