School of Health Sciences, University of East Anglia, Norwich, UK.
Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
Int J Geriatr Psychiatry. 2018 Jan;33(1):e94-e102. doi: 10.1002/gps.4728. Epub 2017 May 3.
Problems with everyday functioning are linked to reduced well-being in people with dementia (PwD) and their carers. However, previous research has almost solely investigated the performance of everyday activities, and global functioning without analysing individual activities. This study explored how deficits in initiating and performing individual activities were associated with carer burden and poorer quality of life of carers and PwD.
Carers of people with mild dementia were recruited via 10 National Health Service Trusts, as well as through attending six carer support groups. Carers were asked to complete the revised Interview for Deteriorations in Daily Living Activities in Dementia 2 (R-IDDD2), and measures on carer burden, well-being, and person with dementia well-being. Data were analysed using correlation analysis.
Two hundred and seventy-two carers completed the R-IDDD2. Carers were grouped into those with low or high ratings of well-being based on the mean scores. All but three activities on the initiative and/or performance scale were significantly associated with carer burden and carer and PwD quality of life. Engaging in hobbies and maintaining an active social life were most strongly associated with carer and PwD well-being. Initiating computer use, driving, and medication management were not related to carer burden.
Findings from this study can have direct implications for improving care management early in the disease. Post-diagnostic support needs to provide more opportunities for PwD, and their carers, to engage in social groups, whilst interventions targeted at living well with dementia need to particularly improve the initiative of engaging in individual hobbies. Copyright © 2017 John Wiley & Sons, Ltd.
日常功能障碍与痴呆患者（PwD）及其照顾者的幸福感降低有关。然而，以前的研究几乎完全调查了日常活动的表现，而没有分析整体功能，也没有分析个体活动。本研究探讨了在分析个体活动的启动和执行方面的缺陷如何与照顾者负担以及照顾者和 PwD 的生活质量较差相关。
通过 10 家国民保健服务信托基金以及参加 6 个照顾者支持小组招募轻度痴呆症患者的照顾者。要求照顾者填写修订后的痴呆症日常生活活动恶化访谈 2 版（R-IDDD2），以及照顾者负担、幸福感和 PwD 幸福感的测量。使用相关分析对数据进行分析。
272 名照顾者完成了 R-IDDD2。根据平均得分，将照顾者分为幸福感评分低或高的两组。主动性和/或绩效量表上的除三项活动外，所有活动均与照顾者负担以及照顾者和 PwD 的生活质量显著相关。从事爱好和保持积极的社交生活与照顾者和 PwD 的幸福感关系最密切。启动计算机使用、驾驶和药物管理与照顾者负担无关。
本研究的结果可以直接改善疾病早期的护理管理。诊断后支持需要为 PwD 及其照顾者提供更多参与社会团体的机会，而以良好生活为目标的干预措施需要特别提高参与个人爱好的主动性。版权所有 © 2017 约翰威立父子有限公司。
