Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China (Email:
Chin Med J (Engl). 2013;126(18):3417-21.
Dementia is a chronic progressive disease seriously affecting the patient's daily life and working skills and may cause the patient disability and dependence. Thus, caring for dementia patients inevitably falls on families in the mainland of China. Unfortunately, there are rarely enough reports available about mental health and social support in family caregivers for domestic dementia patients. This study aimed to investigate the changes in psychological status and social support in domestic dementia family caregivers and hope the government and relevant departments pay more attention to the family caregiver's psychological change, which may be better for dementia patients.
Fifty-eight immediate family caregivers (family group) for dementia patients, including 21 Alzheimer's disease (AD) and 37 vascular dementia inpatients, were recruited for interview. Fifty-eight age- and sex-matched normal volunteers (control group) were also interviewed in the same period. The psychiatric distress was assessed by the Symptom Checklist 90 (SCL-90), family functioning was assessed by the Family Assessment Device (FAD), and the social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Group differences were analyzed using unpaired t test for comparison of SCL-90, FAD, and MSPSS mean scores. Pearson's correlation coefficient was used to find the association between the various dimensions of FAD and the social support from dementia family caregivers.
Except phobic anxiety dimension, the other dimensions of SCL-90 mean scores were significantly higher in the family group than those in the control group (P < 0.05). In the family group, except affective involvement dimension, the other dimensions of FAD mean scores were within the scope of unhealthy family functioning. Significant differences in problem solving, communication, roles, affective responsiveness, behavioral control, general functioning, and the total MSPSS mean scores were seen between the family group and the control group (P < 0.01). Except affective involvement dimension, the other dimensions of the family functioning correlated with the perceived social support in the family group (P < 0.05 or 0.01).
Dementia patients have a negative effect on families' mental health in the mainland of China. Dementia family caregivers experience defected family functioning and low levels of social support.
痴呆是一种慢性进行性疾病，严重影响患者的日常生活和工作技能，可能导致患者残疾和依赖。因此，照顾痴呆患者不可避免地落在中国内地的家庭身上。不幸的是，关于国内痴呆患者家庭照顾者的心理健康和社会支持，几乎没有足够的报道。本研究旨在探讨家庭痴呆患者照顾者心理状态和社会支持的变化，希望政府和相关部门更加关注家庭照顾者的心理变化，这可能对痴呆患者更好。
对 58 名痴呆患者的直系亲属（家庭组）进行访谈，其中阿尔茨海默病（AD）21 例，血管性痴呆 37 例。同期还对 58 名年龄和性别匹配的正常志愿者（对照组）进行了访谈。采用症状自评量表 90（SCL-90）评估精神疾病困扰，采用家庭评估量表（FAD）评估家庭功能，采用多维感知社会支持量表（MSPSS）评估社会支持。采用配对 t 检验比较 SCL-90、FAD 和 MSPSS 均值得分的组间差异。采用 Pearson 相关系数分析 FAD 各维度与痴呆家庭照顾者社会支持的相关性。
家庭组除恐怖焦虑维度外，其他 SCL-90 维度得分均显著高于对照组（P < 0.05）。家庭组除情感卷入维度外，FAD 各维度得分均在不健康家庭功能范围内。家庭组在问题解决、沟通、角色、情感反应、行为控制、一般功能和 MSPSS 总分方面与对照组存在显著差异（P < 0.01）。除情感卷入维度外，家庭组其他家庭功能维度与感知社会支持呈正相关（P < 0.05 或 0.01）。
痴呆患者对中国内地家庭的心理健康有负面影响。痴呆患者家庭照顾者经历家庭功能缺陷和社会支持水平低。
