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管理痴呆症的自我效能感可能有助于预防阿尔茨海默病患者照料者的负担和抑郁。

Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers.

机构信息

Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland.

出版信息

Aging Ment Health. 2011 Aug;15(6):663-70. doi: 10.1080/13607863.2011.562179. Epub 2011 May 24.

Abstract

BACKGROUND

Self-efficacy is the belief that one can perform a specific task or behaviour and is a modifiable attribute which has been shown to influence health behaviours. Few studies have examined the relationship between self-efficacy for dementia-related tasks and symptoms of burden and depression in caregivers.

METHODS

Eighty four patient/caregiver dyads with Alzheimer's disease were recruited through a memory clinic. Patient function, cognition and neuropsychiatric symptoms were assessed together with caregiver burden, personality, depressive symptoms, coping strategies and self-efficacy for completing tasks related to dementia care.

RESULTS

33% (28) of caregivers reported significant depressive symptoms (CES-D  ≥  10). In multivariate analyses, caregiver burden was predicted by self-efficacy for symptom management, neuroticism, patient function and neuropsychiatric symptoms while caregiver depression was predicted by self-efficacy for symptom management, caregiver educational level, neuroticism, emotion-focused coping, dysfunctional coping and patient function. In patients with moderate to severe impairment (MMSE  ≤  20), self-efficacy for symptom management behaved as a mediator between patient neuropsychiatric symptoms and symptoms of burden and depression in caregivers.

CONCLUSIONS

Further longitudinal investigation is warranted to determine if self-efficacy might be usefully considered a target in future interventional studies to alleviate symptoms of burden and depression in Alzheimer's caregivers.

摘要

背景

自我效能感是指一个人能够执行特定任务或行为的信念,是一种可改变的属性,已被证明会影响健康行为。很少有研究检查与痴呆症相关任务的自我效能感与照顾者的负担和抑郁症状之间的关系。

方法

通过记忆诊所招募了 84 对患有阿尔茨海默病的患者/照顾者。评估了患者的功能、认知和神经精神症状,以及照顾者的负担、个性、抑郁症状、应对策略和完成与痴呆症护理相关任务的自我效能感。

结果

33%(28)的照顾者报告有明显的抑郁症状(CES-D ≥ 10)。在多变量分析中,照顾者负担由症状管理的自我效能感、神经质、患者功能和神经精神症状预测,而照顾者抑郁由症状管理的自我效能感、照顾者教育程度、神经质、情绪聚焦应对、功能失调应对和患者功能预测。在中度至重度受损的患者(MMSE ≤ 20)中,症状管理的自我效能感在患者神经精神症状与照顾者的负担和抑郁症状之间表现为中介。

结论

需要进一步的纵向研究来确定自我效能感是否可以被认为是未来干预研究中的一个目标,以减轻阿尔茨海默病照顾者的负担和抑郁症状。

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