Department of Psychiatry, University of Michigan, Ann Arbor, MI.
School of Nursing, University of Michigan, Ann Arbor, MI.
Am J Geriatr Psychiatry. 2018 May;26(5):548-556. doi: 10.1016/j.jagp.2017.12.004. Epub 2017 Dec 13.
Behavioral and psychological symptoms of dementia (BPSD) are common, often challenging to manage, and may erode caregivers' well-being. Few studies have explored caregivers' perspectives of what causes these behaviors, but such attributions may be important-particularly if they negatively impact the care dyad. This study examined causal attributions about BPSD among individuals caring for a family member with dementia.
In-depth qualitative data were obtained from family caregivers of older adults with dementia.
As part of a larger study (NINR R01NR014200), four focus groups were conducted with caregivers by an experienced facilitator.
A total of 26 family caregivers participated in the four focus groups.
Caregivers reported their own attributions about the causes of their care recipient's BPSD. Sessions were audio-recorded. Data were transcribed, coded to determine relevant concepts, and reduced to identify major categories.
Five categories were determined. Caregivers attributed BPSD to: 1) neurobiological disease factors; 2) physical symptoms or comorbid health conditions; 3) psychological reactions to dementia; 4) shifting social roles and relationships following dementia onset; and 5) environmental changes such as lack of routine and medical transitions (e.g., hospitalization). Despite this seemingly multifactorial attribution to BPSD etiology, a number of respondents also indicated that BPSD were at least partly within the care recipient's control.
Family caregivers attribute BPSD to a range of care recipient and environmental factors. Caregivers' own causal beliefs about BPSD may reflect unmet educational needs that should be considered in the development of targeted interventions to minimize caregiving stress.
痴呆症患者的行为和心理症状（BPSD）很常见，通常难以管理，并且可能会损害照顾者的幸福感。很少有研究探讨照顾者对这些行为产生原因的看法，但这些归因可能很重要——尤其是如果它们对护理双方产生负面影响的话。本研究探讨了照顾痴呆症患者的个体对 BPSD 的归因。
从痴呆症老年患者的家庭成员照顾者那里获得了深入的定性数据。
作为一项更大研究（NINR R01NR014200）的一部分，由一位经验丰富的主持人对照顾者进行了四次焦点小组讨论。
共有 26 名家庭照顾者参加了这四个焦点小组。
照顾者报告了他们自己对护理对象 BPSD 原因的归因。会议进行了录音。对数据进行了转录、编码以确定相关概念，并进行了简化以确定主要类别。
确定了五个类别。照顾者将 BPSD 归因于：1）神经生物学疾病因素；2）身体症状或合并健康状况；3）对痴呆症的心理反应；4）痴呆症发作后社会角色和关系的转变；以及 5）环境变化，例如缺乏常规和医疗过渡（例如，住院）。尽管对 BPSD 病因的这种归因似乎是多因素的，但许多受访者也表示，BPSD 在一定程度上至少在护理对象的控制范围内。
家庭照顾者将 BPSD 归因于一系列护理对象和环境因素。照顾者自己对 BPSD 的因果信念可能反映了未满足的教育需求，在制定有针对性的干预措施以最大程度地减少照顾压力时应考虑这些需求。
