Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
ESH (Environment Safety and Health) Management Department, Innolux Corporation, Tainan, Taiwan.
Arch Gerontol Geriatr. 2019 Mar-Apr;81:25-30. doi: 10.1016/j.archger.2018.11.009. Epub 2018 Nov 17.
Due to the presence of neuropsychiatric behaviors and the decreased ability for activities of daily living (ADLs), family caregivers experience high burden levels in caring for people with dementia (PWD). This study sought to test the mediating role of caregiving hours in association with PWDs' ability for basic activities of daily living (BADL) function or neuropsychiatric behaviors and caregiver burden.
This study used two waves of survey data, collected between 2013 and 2016, from 186 PWD-caregiver dyads in a dementia clinic at a teaching hospital in southern Taiwan. Two sets of multiple linear regression models were used to analyze the relationships between the changes in patients' BADL function, patients' neuropsychiatric behaviors, caregiving hours in ADL (including BADL and Instrumental ADL), and caregiver burden (measured using Zarit Burden Interview). Bootstrapping methods were used to detect the mediating effects of caregiving hours in ADL if the 95% confidence interval (CI) did not cover 0.
Caregiving hours in BADL mediated the relationship of PWDs' BADL function and caregiver burden (effect = -0.0137, 95% bootstrap CI = -0.0379, -0.0003). However, such mediating effects were not found in the relationship of PWDs' neuropsychiatric behaviors and caregiver burden.
In order to relieve caregiver burden, respite care services for caregivers for PWD should target services that assist with PWD's BADL.
由于存在神经精神行为和日常生活活动能力（ADL）下降，照顾痴呆症患者（PWD）的家庭照顾者承受着很高的负担。本研究旨在测试照顾时间与 PWD 的基本日常生活活动（BADL）功能或神经精神行为和照顾者负担之间的关联的中介作用。
本研究使用了 2013 年至 2016 年间在台湾南部一家教学医院的痴呆症诊所收集的 186 对 PWD-照顾者的两波调查数据。使用两套多重线性回归模型来分析患者 BADL 功能、患者神经精神行为、ADL（包括 BADL 和工具性 ADL）中的照顾时间以及照顾者负担（使用 Zarit 负担访谈测量）的变化之间的关系。如果 95%置信区间（CI）不包括 0，则使用自举法来检测 ADL 中的照顾时间的中介效应。
BADL 中的照顾时间介导了 PWD 的 BADL 功能和照顾者负担之间的关系（效应=-0.0137，95%bootstrap CI=-0.0379，-0.0003）。然而，在 PWD 的神经精神行为和照顾者负担之间的关系中，没有发现这种中介效应。
为了减轻照顾者的负担，应该为照顾 PWD 的照顾者提供喘息服务，以帮助 PWD 的 BADL。
