Kovaleva Mariya, Spangler Sydney, Clevenger Carolyn, Hepburn Kenneth
J Psychosoc Nurs Ment Health Serv. 2018 Oct 1;56(10):36-43. doi: 10.3928/02793695-20180329-04. Epub 2018 Apr 19.
Caregivers of individuals with dementia are at risk for chronic stress and social isolation. These exogenous factors may lead to perceived stress and perceived loneliness-psychosocial endogenous (subjective) elements of caregiving experience. Chronic stress and perceived loneliness may disrupt neuroendocrine and neuroimmunological regulation, creating low-grade systemic inflammation, promoting proinflammatory gene expression, and expediting cellular aging (endogenous physiological factors). These disturbances may enhance caregivers' risk for chronic conditions of inflammatory pathogenesis. Thus, caregivers' perceived stress and perceived loneliness may form a symptom cluster that can serve as a marker of risks for physical and mental illness. Due to the overwhelming reliance on family caregivers within the increasing population of individuals with dementia, it is essential that clinicians inquire about caregivers' perceived stress and perceived loneliness, are competent in supporting and educating caregivers, and are knowledgeable about specific resources for caregivers. [Journal of Psychosocial Nursing and Mental Health Services, 56(10), 36-43.].
痴呆症患者的照料者面临慢性压力和社会隔离的风险。这些外部因素可能导致感知压力和感知孤独感——照料经历中的心理社会内在（主观）因素。慢性压力和感知孤独感可能会扰乱神经内分泌和神经免疫调节，引发低度全身性炎症，促进促炎基因表达，并加速细胞衰老（内在生理因素）。这些干扰可能会增加照料者患炎症性发病机制慢性病的风险。因此，照料者的感知压力和感知孤独感可能形成一个症状群，可作为身心健康疾病风险的标志物。由于痴呆症患者数量不断增加，对家庭照料者的依赖程度极高，临床医生必须询问照料者的感知压力和感知孤独感，具备支持和教育照料者的能力，并了解针对照料者的特定资源。[《心理社会护理与心理健康服务杂志》，56(10)，36 - 43。]
