Department of Mental Health Sciences, UCL, 67-73 Riding House Street, 2nd Floor, Charles Bell House, London W1W7EJ, UK.
Br J Psychiatry. 2010 Jun;196(6):480-5. doi: 10.1192/bjp.bp.109.071811.
A third of family carers of people with dementia report abusive behaviour towards the person for whom they are caring. This is the first longitudinal study to investigate such behaviour.
To test our hypotheses that carers' reports of abusive behaviour would increase over time, and that change in abuse scores would be predicted by change in anxiety and depression scores.
In total, 131 (71.6%) of the family/friend dementia carers consecutively recruited from new referrals to Essex and London community mental health teams who were interviewed at baseline, completed the revised Modified Conflict Tactics Scale to measure abuse 1 year later.
Sixty-three (48.1%) of the carers reported any abusive behaviour at baseline compared with 81 (61.8%) a year later (chi(2) = 6.9, P = 0.009). An increase in abuse scores was predicted by an increase in anxiety and depressive symptoms (respectively beta = 0.32, t = 3.9, P<0.001 and beta = 0.24, t = 2.9, P = 0.005), and by less domiciliary care at baseline (beta = -0.18, t = -2.2, P = 0.031).
Most abusive behaviour reported by carers at baseline persisted or worsened in the following year, despite contact with specialist services. We suggest that trials of psychological interventions shown to reduce anxiety and depression in the carers of people with dementia are needed to determine whether they also reduce elder abuse, and can be delivered cost-effectively within the National Health Service (NHS).
三分之一的痴呆症患者的家庭护理人员报告对他们所照顾的人有虐待行为。这是第一项调查此类行为的纵向研究。
检验我们的假设，即护理人员报告的虐待行为会随着时间的推移而增加，并且虐待评分的变化可以预测焦虑和抑郁评分的变化。
共对来自埃塞克斯和伦敦社区心理健康团队新转介的 131 名（71.6%）家庭/朋友痴呆症护理人员进行了连续招募，他们在基线时接受了访谈，一年后完成了修订后的修改后的冲突策略量表以测量虐待行为。
63 名（48.1%）护理人员在基线时报告了任何虐待行为，而一年后为 81 名（61.8%）（卡方（2）= 6.9，P = 0.009）。虐待评分的增加可由焦虑和抑郁症状的增加预测（分别为β= 0.32，t = 3.9，P <0.001 和β= 0.24，t = 2.9，P = 0.005），以及基线时的家庭护理较少（β= -0.18，t = -2.2，P = 0.031）。
尽管与专科服务有接触，但大多数护理人员在基线时报告的虐待行为在接下来的一年中持续或恶化。我们建议需要进行心理干预试验，以确定这些试验是否可以减轻痴呆症患者家属的焦虑和抑郁，并且可以在国民保健服务（NHS）中以具有成本效益的方式提供。
