Vatter Sabina, McDonald Kathryn R, Stanmore Emma, Clare Linda, Leroi Iracema
1 Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
2 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.
J Geriatr Psychiatry Neurol. 2018 Nov;31(6):319-328. doi: 10.1177/0891988718802104. Epub 2018 Sep 24.
Providing care to people with Parkinson-related dementia (PwPRD) may result in significant stress, strain, and burden for life partners. A common measurement of life partner burden is the Zarit Burden Interview (ZBI), which considers "burden" as a unitary concept; however, burden is highly complex and most likely comprises several dimensions. This study aimed to explore the factor structure of the ZBI in life partners of PwPRD and to examine the relationships among the emerging factors and the demographic and clinical features.
Life partners of PwPRD participated in home-based quantitative assessments and self-completed postal questionnaires. The assessment battery included ZBI, measures of relationship satisfaction, mood, stress, resilience, health, quality of life, feelings related to care provision, and sociodemographic questions. Data on PwPRDs' motor and neuropsychiatric symptom severity were also elicited in home-based assessments.
An exploratory factor analysis (principal axis factoring) of ZBI, conducted with 127 life partners, revealed five burden dimensions: social and psychological constraints, personal strain, interference with personal life, concerns about future, and guilt. These burden factors were associated with lower relationship satisfaction, mental health, and resilience, and higher stress, anxiety, depression, resentment, negative strain, and PwPRD motor severity. In multiple linear regression analyses, where each factor score was the dependent variable, stress, negative strain, and resentment emerged as significant predictors of specific burden dimensions.
Burden is a complex and multidimensional construct. Interventions should address specific types of burden among life partners of PwPRD to support couples' relationships and maintain quality of life.
为帕金森病相关痴呆患者(PwPRD)提供护理可能会给其生活伴侣带来巨大的压力、紧张和负担。生活伴侣负担的一种常见测量方法是 Zarit 负担访谈(ZBI),该方法将“负担”视为一个单一概念;然而,负担是高度复杂的,很可能包含多个维度。本研究旨在探讨 PwPRD 生活伴侣中 ZBI 的因素结构,并检验新出现的因素与人口统计学和临床特征之间的关系。
PwPRD 的生活伴侣参与了家庭定量评估并自行填写邮寄问卷。评估项目包括 ZBI、关系满意度测量、情绪、压力、恢复力、健康、生活质量、与护理相关的感受以及社会人口学问题。在家庭评估中还获取了 PwPRD 的运动和神经精神症状严重程度的数据。
对 127 名生活伴侣进行的 ZBI 探索性因素分析(主轴因子分析)揭示了五个负担维度:社会和心理限制、个人紧张、对个人生活的干扰、对未来的担忧以及内疚。这些负担因素与较低的关系满意度、心理健康和恢复力相关,与较高的压力、焦虑、抑郁、怨恨、负面紧张以及 PwPRD 运动严重程度相关。在多元线性回归分析中,以每个因素得分作为因变量,压力、负面紧张和怨恨成为特定负担维度的显著预测因素。
负担是一个复杂的多维结构。干预措施应针对 PwPRD 生活伴侣中特定类型的负担,以支持夫妻关系并维持生活质量。