Li Ruijie, Chong Mei Sian, Chan Peng Chew Mark, Tay Bee Gek Laura, Ali Noorhazlina Binte, Lim Wee Shiong
Health Services and Outcomes Research, National Healthcare Group, Singapore, Singapore.
Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Front Med (Lausanne). 2018 Mar 22;5:79. doi: 10.3389/fmed.2018.00079. eCollection 2018.
Recent studies on the Zarit Burden Interview (ZBI) support the existence of a unique factor, worry about caregiving performance (WaP), beyond role and personal strain. Our current study aims to confirm the existence of WaP within the multidimensionality of ZBI and to determine if predictors of WaP differ from the role and personal strain. We performed confirmatory factor analysis (CFA) on 466 caregiver-patient dyads to compare between one-factor (total score), two-factor (role/personal strain), three-factor (role/personal strain and WaP), and four-factor models (role strain split into two factors). We conducted linear regression analyses to explore the relationships between different ZBI factors with socio-demographic and disease characteristics, and investigated the stage-dependent differences between WaP with role and personal strain by dyadic relationship. The four-factor structure that incorporated WaP and split role strain into two factors yielded the best fit. Linear regression analyses reveal that different variables significantly predict WaP (adult child caregiver and Neuropsychiatric Inventory Questionnaire (NPI-Q) severity) from role/personal strain (adult child caregiver, instrumental activities of daily living, and NPI-Q distress). Unlike other factors, WaP was significantly endorsed in early cognitive impairment. Among spouses, WaP remained low across Clinical Dementia Rating (CDR) stages until a sharp rise in CDR 3; adult child and sibling caregivers experience a gradual rise throughout the stages. Our results affirm the existence of WaP as a unique factor. Future research should explore the potential of WaP as a possible intervention target to improve self-efficacy in the milder stages of burden.
近期关于 Zarit 负担访谈（ZBI）的研究支持了一个独特因素的存在，即除了角色负担和个人压力之外，对护理表现的担忧（WaP）。我们当前的研究旨在确认 WaP 在 ZBI 的多维度结构中是否存在，并确定 WaP 的预测因素是否与角色负担和个人压力不同。我们对 466 对照顾者 - 患者二元组进行了验证性因素分析（CFA），以比较单因素模型（总分）、双因素模型（角色/个人压力）、三因素模型（角色/个人压力和 WaP）和四因素模型（角色压力分为两个因素）。我们进行了线性回归分析，以探讨不同 ZBI 因素与社会人口学和疾病特征之间的关系，并通过二元关系研究 WaP 与角色负担和个人压力之间的阶段依赖性差异。纳入 WaP 并将角色压力分为两个因素的四因素结构拟合效果最佳。线性回归分析表明，不同变量对 WaP（成年子女照顾者和神经精神科问卷（NPI - Q）严重程度）的预测与对角色/个人压力（成年子女照顾者、日常生活工具性活动和 NPI - Q 痛苦）的预测显著不同。与其他因素不同，WaP 在早期认知障碍中得到显著认可。在配偶中，WaP 在临床痴呆评定量表（CDR）各阶段一直较低，直到 CDR 3 时急剧上升；成年子女和兄弟姐妹照顾者在各个阶段经历逐渐上升。我们的结果证实了 WaP 作为一个独特因素的存在。未来的研究应探索 WaP 作为一个可能的干预靶点的潜力，以在负担较轻的阶段提高自我效能感。
