Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia.
Health Soc Care Community. 2013 Jul;21(4):411-22. doi: 10.1111/hsc.12030. Epub 2013 Mar 18.
While many people with dementia require institutional care, having a co-resident carer improves the likelihood that people can live at home. Although caregiving can have positive aspects, carers still report a high need for respite. Despite this need, the use of respite services for carers of people with dementia is often low. This article investigates carer beliefs regarding out-of-home respite services and why some carers do not utilise them. A total of 152/294 (51.7%) carers of community-dwelling people with dementia (NSW, Australia) who were sent a survey completed it (November 2009-January 2010). Despite reporting unmet need for both services, 44.2% of those surveyed were not utilising day respite and 60.2% were not utilising residential respite programmes. Binary logistic regression models were used to examine factors associated with non-use using the Theory of Planned Behaviour within an expanded Andersen Behavioural Model on a final sample of 113 (due to missing data). The model explained 66.9% of the variation for day centres, and 42% for residential respite services. Beliefs that service use would result in negative outcomes for the care recipient were strongly associated with non-use of both day care [OR 13.11; 95% CI (3.75, 45.89)] and residential respite care [OR 6.13; 95% CI (2.02, 18.70)] and were more strongly associated with service non-use than other predisposing, impeding and need variables. For some carers who used services despite negative outcome beliefs, the benefits of respite service use may also be diminished. To improve use of out-of-home respite services in this vulnerable group, service beliefs should be addressed through service development and promotion that emphasises benefits for both carer and care recipients. Future research utilising behavioural service models may also be improved via the inclusion of service beliefs in the study of health and social service use.
虽然许多痴呆症患者需要机构护理，但有共同居住的护理人员可以提高患者居家生活的可能性。尽管护理工作可能有积极的方面，但护理人员仍报告需要大量休息。尽管有这种需求，但痴呆症患者护理人员使用休息服务的情况往往很低。本文调查了护理人员对家庭外休息服务的看法，以及为什么有些护理人员不使用这些服务。2009 年 11 月至 2010 年 1 月，共向 294 名居住在社区的痴呆症患者（澳大利亚新南威尔士州）的护理人员发送了一份调查，其中 152 名（51.7%）完成了调查。尽管报告了对这两种服务的需求未得到满足，但接受调查的人中，有 44.2%没有使用日间休息服务，有 60.2%没有使用住宿休息服务。使用计划行为理论，在一个最终样本为 113 人的扩展安德森行为模型中，对非使用情况进行二元逻辑回归模型分析（由于缺失数据）。该模型解释了日间中心的 66.9%的变化，解释了住宿休息服务的 42%的变化。认为服务使用会对护理接受者产生负面结果的信念，与日间护理[OR 13.11；95%置信区间（3.75，45.89）]和住宿休息服务[OR 6.13；95%置信区间（2.02，18.70）]的非使用强烈相关，并且与其他倾向、阻碍和需求变量相比，与服务非使用的相关性更强。对于一些尽管存在负面结果信念但仍使用服务的护理人员来说，休息服务的好处可能也会减少。为了提高这个弱势群体对家庭外休息服务的使用，应通过强调对护理人员和护理接受者都有益处的服务开发和推广来解决服务信念问题。未来利用行为服务模型的研究也可以通过在健康和社会服务使用的研究中纳入服务信念来改进。
