Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Int Psychogeriatr. 2012 Dec;24(12):1953-61. doi: 10.1017/S1041610212001354.
The caregiver burden on foreign paid caregivers (FPCs) is currently not well understood. This study identified predictors and differences in caregiver burden between FPCs and family caregivers who provided care for patients with dementia.
We recruited 489 patients with dementia (diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition) and used the Neuropsychiatric Inventory (NPI) and Clinical Dementia Rating (CDR) Scale to assess their neuropsychiatric behavioral problems and severity of dementia. All caregivers [FPCs (n = 42) and family caregivers with (n = 42) and without (n = 447) FPCs] completed three questionnaires: the Zarit Burden Interview (ZBI), the Center for Epidemiological Studies-Depression Scale (CES-D), and caregivers' knowledge of dementia (KD). To understand caregiver burden, we analyzed the correlations between ZBI and other variables and investigated the differences between family caregivers and FPCs.
NPI and CDR scores were higher among patients assisted by FPCs than among those whose families did not employ FPCs. Burdens were greater among family caregivers assisted by FPCs than among FPCs and family caregivers who were not assisted by FPCs. Family caregivers had greater knowledge of dementia than did FPCs. For family caregivers, CES-D scores (Spearman's r = 0.650; p < 0.01) and patients' NPI scores (Spearman's r = 0.471; p < 0.01) were correlated with caregiver burden. For FPCs, only CES-D scores (Spearman's r = 0.511; p < 0.01) were correlated with caregiver burden. A linear regression model showed that CES-D scores contributed most to caregiver burden in all groups [β = 0.560 (family caregivers without FPCs), 0.546 (family caregivers with FPCs), and 0.583 (FPCs); p < 0.005].
Both family caregivers and FPCs need emotional support. Adequate treatment to reduce the neuropsychiatric symptoms of patients with dementia might reduce the burden on family caregivers.
目前，对外籍佣工照顾者（FPC）的照顾者负担还没有得到很好的理解。本研究确定了 FPC 和照顾痴呆患者的家庭照顾者之间照顾者负担的预测因素和差异。
我们招募了 489 名痴呆患者（根据《精神障碍诊断与统计手册》第 4 版诊断），使用神经精神病学问卷（NPI）和临床痴呆评定量表（CDR）来评估他们的神经精神行为问题和痴呆严重程度。所有照顾者[FPC（n=42）和有（n=42）和没有（n=447）FPC 的家庭照顾者]完成了三个问卷：Zarit 负担访谈（ZBI）、流行病学研究中心抑郁量表（CES-D）和照顾者对痴呆的知识（KD）。为了了解照顾者的负担，我们分析了 ZBI 与其他变量之间的相关性，并调查了家庭照顾者和 FPC 之间的差异。
FPC 辅助的患者的 NPI 和 CDR 评分高于没有 FPC 辅助的患者。有 FPC 辅助的家庭照顾者的负担大于没有 FPC 辅助的家庭照顾者和 FPC。家庭照顾者对痴呆的了解多于 FPC。对于家庭照顾者，CES-D 评分（Spearman's r = 0.650；p < 0.01）和患者的 NPI 评分（Spearman's r = 0.471；p < 0.01）与照顾者负担相关。对于 FPC，只有 CES-D 评分（Spearman's r = 0.511；p < 0.01）与照顾者负担相关。线性回归模型显示，CES-D 评分在所有组中对照顾者负担的贡献最大[β=0.560（无 FPC 的家庭照顾者），0.546（有 FPC 的家庭照顾者）和 0.583（FPC）；p<0.005]。
家庭照顾者和 FPC 都需要情感支持。充分治疗以减轻痴呆患者的神经精神症状可能会减轻家庭照顾者的负担。
