Wang Zhixin, Ma Caiyun, Han Hongjuan, He Runlian, Zhou Liye, Liang Ruifeng, Yu Hongmei
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
Department of Mathematics, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China.
Int J Geriatr Psychiatry. 2018 Jun 1. doi: 10.1002/gps.4910.
Although there are many studies on the relationship between patient-related factors and negative caregiver outcomes, the specifics of this relationship are poorly understood. We aimed to examine whether caregiver social support moderated the relationship between patient factors and negative outcomes for caregivers of community-dwelling older adults with Alzheimer's disease (AD), and whether positive aspects of caregiving mediated this relationship.
We conducted a cross-sectional study of patients diagnosed with AD from 2 hospitals and 3 communities in Taiyuan, China, and their caregivers. Latent moderated structural equations and the bias-corrected percentile bootstrap method were used to estimate the parameters of moderating and mediating effects, respectively.
Social support significantly moderated the effects of AD patient cognitive function (P < 0.001) and depression (P = 0.001) on caregiver burden. Positive aspects of caregiving completely mediated the association between patient depression and caregiver burden (P = 0.006), caregiver anxiety (P = 0.007), and caregiver depression (P = 0.034).
The findings identify social support as a moderator and positive aspects of caregiving as a mediator of the relationship between patient-related factors and negative caregiver outcomes. The results suggest that health care providers must offer more effective social support for caregivers. In addition, prompt identification of patient and caregiver emotional states could help to improve quality of life.
尽管有许多关于患者相关因素与照料者负面结果之间关系的研究,但这种关系的具体情况仍知之甚少。我们旨在研究照料者社会支持是否调节了社区居住的阿尔茨海默病(AD)老年患者的患者因素与照料者负面结果之间的关系,以及照料的积极方面是否介导了这种关系。
我们对来自中国太原2家医院和3个社区的AD诊断患者及其照料者进行了一项横断面研究。分别使用潜在调节结构方程和偏差校正百分位数Bootstrap方法来估计调节效应和中介效应的参数。
社会支持显著调节了AD患者认知功能(P < 0.001)和抑郁(P = 0.001)对照料者负担的影响。照料的积极方面完全介导了患者抑郁与照料者负担(P = 0.006)、照料者焦虑(P = 0.007)和照料者抑郁(P = 0.034)之间的关联。
研究结果确定社会支持为调节因素,照料的积极方面为患者相关因素与照料者负面结果之间关系的中介因素。结果表明,医疗保健提供者必须为照料者提供更有效的社会支持。此外,及时识别患者和照料者的情绪状态有助于提高生活质量。