School of Allied Health,Australian Catholic University,Brisbane,Queensland,Australia.
Institute for Health and Ageing,Australian Catholic University,Melbourne,Victoria,Australia.
Int Psychogeriatr. 2018 Nov;30(11):1619-1637. doi: 10.1017/S1041610218000303. Epub 2018 Apr 18.
ABSTRACTBackground:The care of community-dwelling people with dementia often occurs in the context of pre-existing family relationships. The presence of dementia can result in changes to the quality of those relationships. The purpose of this systematic review is to identify factors that enhance or challenge the quality of spousal or offspring relationships in the context of dementia.
Both qualitative and quantitative studies were included in a systematic review of the literature. Thematic analysis of results was conducted that examined factors related to the relationship quality of community dwelling people with dementia and their spousal or offspring carer. Meta-analysis was not possible due to the heterogeneity of the included studies.
Four themes were extracted from seven qualitative studies: connection to the carer role; identity of the people with dementia; current efforts to maintain relationship connection; and the dyads response to dementia. Each of these four themes incorporated positive and negative facets that impacted on relationship quality. An analysis of nine quantitative and one mixed methods studies identified four domains: influence of dementia characteristics; connection within the dyad; relationship response to stress and carer burden; and carer demographic factors.
The findings of this review highlight relationship factors that are important for supporting relationship quality for the people with dementia and the carer individually, as well as for the dyad together. These findings extend an existing framework of relationship quality in dementia. Implications for interventions to enhance relationship quality in the dementia context are discussed.
摘要背景：居住在社区中的痴呆症患者的护理通常发生在预先存在的家庭关系背景下。痴呆症的存在会导致这些关系的质量发生变化。本系统评价的目的是确定在痴呆症背景下增强或挑战配偶或子女关系质量的因素。方法：对文献进行了系统评价，包括定性和定量研究。对与居住在社区中的痴呆症患者及其配偶或子女照顾者的关系质量相关的因素进行了主题分析。由于纳入研究的异质性，无法进行荟萃分析。结果：从七项定性研究中提取了四个主题：与照顾者角色的联系；痴呆症患者的身份；目前维持关系联系的努力；以及对痴呆症的双元反应。这四个主题都包含了影响关系质量的积极和消极方面。对九项定量研究和一项混合方法研究的分析确定了四个领域：痴呆症特征的影响；双元关系内的联系；关系对压力和照顾者负担的反应；以及照顾者人口统计学因素。结论：本综述的结果强调了关系因素，这些因素对于支持痴呆症患者和照顾者个体的关系质量以及双元关系的质量都很重要。这些发现扩展了痴呆症中关系质量的现有框架。讨论了在痴呆症背景下增强关系质量的干预措施的意义。
