Borsje Petra, Hems Marleen A P, Lucassen Peter L B J, Bor Hans, Koopmans Raymond T C M, Pot Anne Margriet
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands, Thebe, Region South-East, Goirle, The Netherlands,
Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health and.
Fam Pract. 2016 Aug;33(4):374-81. doi: 10.1093/fampra/cmw009. Epub 2016 Mar 11.
The course of psychological distress in informal caregivers of patients with dementia has been investigated in longitudinal studies with conflicting outcomes.
We investigated the course and determinants of psychological distress in informal caregivers of patients with dementia in primary care.
In this prospective observational cohort study, data were collected at baseline, after 9 and 18 months. We assessed cognition and neuropsychiatric symptoms (NPS) of the patient (Mini-Mental State Examination and Neuropsychiatric Inventory) and psychological distress (Sense of Competence Questionnaire, Center for Epidemiological Studies Depression scale and General Health Questionnaire 12-tem version) of the informal caregivers. Determinants for the course of psychological distress were caregivers' age, gender and relationship with the patient, patients' cognition and NPS, participation in a care program and admission to long-term care facilities (LTCF). With linear mixed models, the course over time for psychological distress and its determinants were explored.
We included 117 informal caregivers, of whom 23.1% had a high risk for depression and 41.0% were identified to be likely to have mental problems at baseline. We found a stable pattern of psychological distress over time. Higher frequency of NPS, informal caregivers' age between 50 and 70 years and being female or spouse were associated with higher psychological distress. For patients who were admitted to a LTCF during the study psychological distress of the informal caregivers improved.
GPs should focus on NPS in patients with dementia and on caregivers' psychological distress and be aware of their risk for depression and mental problems, specifically to those who are spouse, female or between 50 and 70 years of age.
痴呆症患者非正式照料者的心理困扰病程已在纵向研究中进行了调查，但结果相互矛盾。
我们调查了初级保健中痴呆症患者非正式照料者心理困扰的病程及其决定因素。
在这项前瞻性观察队列研究中，在基线、9个月和18个月后收集数据。我们评估了患者的认知和神经精神症状（简易精神状态检查表和神经精神科问卷）以及非正式照料者的心理困扰（能力感问卷、流行病学研究中心抑郁量表和一般健康问卷12项版本）。心理困扰病程的决定因素包括照料者的年龄、性别及其与患者的关系、患者的认知和神经精神症状、参与护理计划以及入住长期护理机构。采用线性混合模型探讨心理困扰及其决定因素随时间的变化过程。
我们纳入了117名非正式照料者，其中23.1%在基线时有高抑郁风险，41.0%被确定在基线时可能有心理问题。我们发现心理困扰随时间呈稳定模式。神经精神症状出现频率较高、非正式照料者年龄在50至70岁之间、女性或配偶身份与较高的心理困扰相关。对于在研究期间入住长期护理机构的患者，非正式照料者的心理困扰有所改善。
全科医生应关注痴呆症患者的神经精神症状以及照料者的心理困扰，并意识到他们有抑郁和心理问题的风险，尤其是对那些配偶、女性或年龄在50至70岁之间的人。
