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神经精神问卷特定项目与痴呆患者照料者负担的关系:系统评价。

The relationship of specific items on the Neuropsychiatric Inventory to caregiver burden in dementia: a systematic review.

机构信息

Westeren Norway University of Applied Science, Førde, Norway.

Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.

出版信息

Int J Geriatr Psychiatry. 2017 Jul;32(7):703-717. doi: 10.1002/gps.4704. Epub 2017 Mar 20.

Abstract

OBJECTIVE

Neuropsychiatric symptoms (NPSs) are common in dementia, and they have been identified as important care-recipient variables in terms of their impact on caregiver burden. The aim of this review was to describe how individual NPSs in dementia, assessed using the Neuropsychiatric Inventory, are associated with caregiver burden.

METHODS

We performed a systematic review of English language, peer-reviewed articles retrieved from MEDLINE, PSYCINFO, and EMBASE.

RESULTS

A total of 13 studies met the inclusion criteria. Four studies examined the association between individual NPSs and caregiver burden using the Spearman rank correlation test, while three used Pearson's correlation test. Of the remaining studies, five used multiple regression analyses and one the chi-squared test. The majority of included studies did not differentiate between dementia subtypes in the analysis or mainly included only caregivers of people with Alzheimer's disease. The Clinical Dementia Rating score and mean Mini-Mental State Examination score indicate mild to moderate dementia. The majority of caregivers were women, most of whom were children (53.8%) or spouses (36%). The data indicated that irritability, followed by agitation, sleep disturbances, anxiety, apathy, and delusion seem to impact caregiver burden the most.

CONCLUSION

Our principal finding is that irritability, agitation, sleep disturbances, anxiety, apathy, and delusion seem to exert the most impact on caregiver burden. Heterogeneity in the measures and statistical analyses used, however, makes it difficult to make conclusive interpretations. Future research in this field would benefit from standardization of the scientific methodology in use. Copyright © 2017 John Wiley & Sons, Ltd.

摘要

目的

神经精神症状(NPSs)在痴呆症中很常见,并且已被确定为影响照顾者负担的重要照顾者变量。本综述的目的是描述使用神经精神病学评定量表评估的痴呆症中的个体 NPSs 如何与照顾者负担相关。

方法

我们对从 MEDLINE、PSYCINFO 和 EMBASE 检索到的英文同行评审文章进行了系统评价。

结果

共有 13 项研究符合纳入标准。四项研究使用 Spearman 秩相关检验研究了个体 NPSs 与照顾者负担之间的关系,而三项研究使用 Pearson 相关检验。在其余研究中,五项研究使用多元回归分析,一项研究使用卡方检验。大多数纳入的研究在分析中没有区分痴呆症亚型,主要只包括阿尔茨海默病患者的照顾者。临床痴呆评定量表评分和平均简易精神状态检查评分表明为轻度至中度痴呆。大多数照顾者是女性,其中大多数是子女(53.8%)或配偶(36%)。数据表明,易激惹、激越、睡眠障碍、焦虑、淡漠和妄想似乎对照顾者负担的影响最大。

结论

我们的主要发现是易激惹、激越、睡眠障碍、焦虑、淡漠和妄想似乎对照顾者负担的影响最大。然而,由于使用的测量和统计分析方法存在异质性,使得难以做出明确的解释。该领域的未来研究将受益于使用的科学方法的标准化。版权所有©2017 约翰威立父子有限公司。

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