Division of Psychiatry,University College London,London, UK.
Institute of Mental Health,University of Nottingham,Nottingham,UK.
Int Psychogeriatr. 2019 Jun;31(6):799-813. doi: 10.1017/S1041610218001394. Epub 2018 Nov 23.
ABSTRACTObjectives:Sense of competence defines a caregiver's feeling of being capable to manage the caregiving task and is an important clinical concept in the caregiving literature. The aim of this review was to identify the factors, both positive and negative, associated with a caregiver's perception of their sense of competence.
A systematic review of the literature was conducted, retrieving both quantitative and qualitative papers from databases PsycINFO, CINAHL, EMBASE, and Medline. A quality assessment was conducted using the STROBE and CASP checklists, and the quality rating informed the inclusion of papers ensuring the evidence was robust. Narrative synthesis was employed to synthesize the findings and to generate an updated conceptual model of sense of competence.
Seventeen papers were included in the review, all of which were moderate to high quality. These included 13 quantitative, three mixed-methods and one qualitative study. Factors associated with sense of competence included: behavioral and psychological symptoms of dementia (BPSD), caregiver depression, gratitude, and the ability to find meaning in caregiving.
The results of this review demonstrate that both positive and negative aspects of caring are associated with caregiver sense of competence. Positive and negative aspects of caregiving act in tandem to influence caregiver perception of their competence. The proposed model of sense of competence aims to guide future research and clinical interventions aimed at improving this domain but requires further testing, as due to the observational nature of the include papers, the direction of causality could not be inferred.
摘要
能力感定义了照顾者对能够管理照顾任务的感觉,是照顾文献中的一个重要临床概念。本研究的目的是确定与照顾者能力感感知相关的积极和消极因素。
对文献进行了系统回顾,从 PsycINFO、CINAHL、EMBASE 和 Medline 数据库中检索了定量和定性论文。使用 STROBE 和 CASP 清单进行了质量评估,并根据质量评分纳入了论文,以确保证据可靠。采用叙述性综合方法对研究结果进行综合,并生成能力感的更新概念模型。
共纳入了 17 篇文献进行综述,这些文献的质量从中等到较高。其中包括 13 项定量研究、3 项混合方法研究和 1 项定性研究。与能力感相关的因素包括:痴呆的行为和心理症状(BPSD)、照顾者抑郁、感激和在照顾中找到意义的能力。
本研究结果表明,照顾的积极和消极方面都与照顾者的能力感有关。积极和消极方面的照顾相互作用,影响照顾者对自己能力的感知。所提出的能力感模型旨在指导未来旨在改善这一领域的研究和临床干预,但需要进一步测试,因为由于纳入论文的观察性质,无法推断因果关系的方向。