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社区中阿尔茨海默病患者家庭照顾者的痛苦负担及相关应对过程

The burden of distress and related coping processes in family caregivers of patients with Alzheimer's disease living in the community.

作者信息

Raggi Alberto, Tasca Domenica, Panerai Simonetta, Neri Walter, Ferri Raffaele

机构信息

Unit of Neurology, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy.

Department of Neurology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.

出版信息

J Neurol Sci. 2015 Nov 15;358(1-2):77-81. doi: 10.1016/j.jns.2015.08.024. Epub 2015 Aug 17.

Abstract

BACKGROUND

Many patients with dementia live in the community and depend on a family member for assistance. Taking care of non-self-sufficient people such as those with dementia causes distress. This study concerns factors contributing to feelings of burden and consequent coping strategies adopted by family caregivers of patients with Alzheimer's disease living in the community.

METHODS

The severity of the caregiver burden (Caregiver Burden Inventory and the Neuropsychiatric Inventory Caregiver Distress Scale) was evaluated in relation to the cognitive, behavioral, functional, mood, motor and comorbidity status in 73 consecutive patients with Alzheimer's disease. The type of coping processes (Coping Orientation to Problem Experienced), and psychosocial and medical variables of caregivers were also investigated and correlated with the degree of their distress.

RESULTS

The amount of burden for caregivers, was found to be positively correlated with several measures of cognitive, psychological, behavioral, and motor impairment of the patients. The severity of caregiver distress was correlated with specific coping strategies, such as seeking for social support, using avoidance behaviors and focusing on problems. Finally, caregivers needing higher levels of familial and/or social support had also higher levels of distress.

CONCLUSIONS

Higher cognitive, psychological, behavioral, and motor impairment of patients with Alzheimer's disease are associated with increasing levels of burden and distress in their caregivers, who need to adopt adequate coping strategies and to seek for familial and social support.

摘要

背景

许多痴呆患者生活在社区中,依靠家庭成员提供帮助。照顾像痴呆患者这样不能自理的人会导致困扰。本研究关注社区中阿尔茨海默病患者的家庭照顾者产生负担感的相关因素以及由此采取的应对策略。

方法

对73例连续的阿尔茨海默病患者,根据其认知、行为、功能、情绪、运动及共病状况,评估照顾者负担的严重程度(采用照顾者负担量表和神经精神科问卷照顾者困扰量表)。还调查了照顾者的应对过程类型(对所经历问题的应对取向)以及心理社会和医学变量,并将其与他们的困扰程度进行关联。

结果

发现照顾者的负担量与患者认知、心理、行为和运动损害的多项指标呈正相关。照顾者困扰程度与特定应对策略相关,如寻求社会支持、采用回避行为和关注问题。最后,需要更高水平家庭和/或社会支持的照顾者也有更高的困扰程度。

结论

阿尔茨海默病患者更高的认知、心理、行为和运动损害与照顾者负担和困扰水平的增加相关,照顾者需要采取适当的应对策略并寻求家庭和社会支持。

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