Psychiatric Skilled Nursing Home 'DrieMaasStede', Argos Zorggroep, Schiedam/VU Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research VU University Amsterdam/VU University Medical Centre, Amsterdam, The Netherlands.
Stichting Wetenschap Balans (Foundation for Scientific Research Geriatric Health Care), Rotterdam/VU Department of General Practice & Elderly Care Medicine, EMGO Institute for Health and Care Research VU University Amsterdam/VU University Medical Centre, Amsterdam, The Netherlands.
Ageing Res Rev. 2014 May;15:76-93. doi: 10.1016/j.arr.2014.03.003. Epub 2014 Mar 25.
Burden in dementia caregivers is a complex and multidimensional construct. Several models of burden and other representations of burden like depression or mental health are described in literature. To clarify the state of science, we systematically reviewed complex models that include both patient and caregiver determinants of caregiver burden.
A review of determinant models of caregiver burden.
Systematic review.
Electronic databases PubMed, PsycInfo and EMbase were searched in December 2013.
Research studies with quantitative outcome measures of caregiver burden or burden-related concepts, including both patient and caregiver functional characteristics as determinants. We categorized the determinant variables in the models and calculated the percentages of proven determinants within each category.
We found 32 studies with burden models and 24 depression and mental health models. Patient behavioral problems, caregiver coping and personality traits and competence are most consistent determinants of caregiver burden, depression and mental health. Behavioral problems are more significant than cognitive disorders or lack of self-care. Of all measured caregiver personality traits, neuroticism has the strongest impact on caregiver burden. Regarding caregiver competences, feeling competent or enjoying higher self-efficacy in general diminish caregiver burden and promote caregiver mental health.
痴呆症照顾者的负担是一个复杂的多维结构。文献中描述了几种负担模型和其他代表负担的概念，如抑郁或心理健康。为了阐明科学现状，我们系统地回顾了包括患者和照顾者决定因素在内的复杂负担模型。
对照顾者负担的决定因素模型进行综述。
系统评价。
2013 年 12 月，在电子数据库 PubMed、PsycInfo 和 EMbase 中进行了搜索。
具有照顾者负担或与负担相关概念的定量结果测量的研究，包括作为决定因素的患者和照顾者功能特征。我们对模型中的决定变量进行了分类，并计算了每个类别中已证明的决定因素的百分比。
我们发现了 32 项具有负担模型和 24 项抑郁和心理健康模型的研究。患者的行为问题、照顾者的应对方式和个性特征与能力是照顾者负担、抑郁和心理健康的最一致决定因素。行为问题比认知障碍或缺乏自我护理更重要。在所有测量的照顾者个性特征中，神经质对照顾者负担的影响最大。关于照顾者的能力，一般来说，感到有能力或享受更高的自我效能感会减轻照顾者的负担并促进照顾者的心理健康。
