Department of Psychological Services and Research, NHS Dumfries & Galloway,Dumfries,Scotland.
Department of Paediatric Psychology and Liaison,Royal Hospital for Sick Children,NHS Lothian,Edinburgh,Scotland.
Int Psychogeriatr. 2018 Nov;30(11):1671-1678. doi: 10.1017/S1041610218000315. Epub 2018 Mar 22.
ABSTRACTBackground:Caring for persons with dementia (PWD) can create "caregiver burden," which is associated with negative outcomes for caregivers and PWD. The ZBI (Zarit Burden Interview) is a widely used unitary measure of caregiver burden. However, recent research has found caregiver burden to be multi-dimensional. The purpose of this study was to explore the factor structure of the ZBI within a sample of UK caregivers. A secondary aim was to identify variables that predicted burden dimensions found.
A total of 110 unpaid community caregivers of PWD completed the ZBI. They also completed the EACQ (Experiential Avoidance in Caregiving Questionnaire), DEX (Dysexecutive Questionnaire), PACS (Positive Aspects of Caregiving Scale), and a demographic questionnaire. ZBI data were analyzed via exploratory factor analysis (principal axis factoring). Relationships between burden factors and other variables were studied using Pearson correlations and multiple regression.
Analysis identified three burden factors, namely direct impact of caregiving, uncertainty around the future, and frustration/embarrassment. A direct impact of caregiving and frustration/embarrassment has been found previously. Uncertainty over the future is a new factor, which was predicted by adult-child caregiver role, highlighting that spouses and adult children are likely to have different burden experiences. Additionally, uncertainty over the future and frustration/embarrassment were inversely predicted by PACS, suggesting that being mindful of positive aspects of caregiving may function as a protective factor for burden.
This study found caregiver burden to be multi-dimensional and uncovered a novel factor in uncertainty over the future, which warrants further exploration. Burden factors were associated with a range of modifiable variables that could be targeted within health and social care interventions to improve outcomes for caregivers and PWD.
摘要
照顾痴呆症患者（PWD）会产生“ caregiver burden”，这与 caregiver和 PWD 的负面结果有关。ZBI（Zarit 负担访谈）是一种广泛使用的单一 caregiver负担衡量标准。然而，最近的研究发现 caregiver burden 是多维度的。本研究的目的是在英国 caregiver 样本中探索 ZBI 的因素结构。次要目的是确定预测发现的负担维度的变量。
共有 110 名无偿社区 PWD 照顾者完成了 ZBI。他们还完成了 EACQ（照顾中的体验回避问卷）、DEX（执行功能障碍问卷）、PACS（照顾的积极方面量表）和一份人口统计问卷。通过探索性因素分析（主成分分析）对 ZBI 数据进行分析。使用 Pearson 相关和多元回归研究了负担因素与其他变量之间的关系。
分析确定了三个负担因素，即直接护理影响、对未来的不确定性以及挫折/尴尬。先前已发现直接护理影响和挫折/尴尬。对未来的不确定性是一个新因素，它由成人-儿童照顾者角色预测，突出表明配偶和成年子女可能有不同的负担体验。此外，对未来的不确定性和挫折/尴尬被 PACS 反向预测，这表明关注照顾的积极方面可能是负担的保护因素。
本研究发现 caregiver burden 是多维度的，并发现了一个新的未来不确定性因素，这值得进一步探索。负担因素与一系列可改变的变量相关，这些变量可以在卫生和社会保健干预中针对这些变量，以改善 caregiver 和 PWD 的结果。
