Department of Public Health,National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan,Taiwan.
Department of Statistics,National Cheng Kung University,Tainan,Taiwan.
Int Psychogeriatr. 2019 Jun;31(6):885-894. doi: 10.1017/S1041610218001382. Epub 2018 Dec 6.
ABSTRACTObjectives:As a degenerative disease, the progression of dementia needs continued care provision and poses both psychological and financial burden for family caregivers of persons with dementia (PWD). This study seeks to compare predictors of care costs and caregiver burden, and to identify modifiable factors that could alleviate the burden faced by dementia caregivers.
This study interviewed 231 PWD-caregiver dyads in a dementia clinic at a teaching hospital in southern Taiwan in 2013. A follow-up study was conducted a year later, and 167 dyads completed the second interview. Data collected included PWD characteristics, caregiver characteristics, relationship to PWD, and social support to caregivers. Caregiver burden was measured with the Zarit Burden Interview instrument. The association between each predictor variable and cost of care and caregiver burden scores was examined using linear mixed models.
Predictors of care costs were found to be different from predictors of caregiver burden: functional declines measured by Katz's activities of daily living (ADL) scale were associated with total cost as compared to behavioral disturbance measured by Neuropsychiatric Inventory (NPI), which showed no impact on care costs. However, NPI was a significant predictor of caregiver burden. Caregivers who were better-off financially also reported significantly lower caregiver burden.
Since predictors of care costs were different from the predictors of caregiver burden, providing training to caregivers in addressing PWD's behavioral disturbance and proving financial assistance to low income caregivers could be effective in reducing caregiver burden.
摘要
痴呆是一种退行性疾病,其病程发展需要持续的护理,这给痴呆患者(PWD)的家庭照顾者带来了心理和经济负担。本研究旨在比较照护费用和照顾者负担的预测因素,并确定可减轻痴呆症照顾者负担的可调节因素。
2013 年,本研究在台湾南部一家教学医院的痴呆症诊所对 231 对 PWD-照顾者进行了访谈。一年后进行了随访研究,有 167 对完成了第二次访谈。收集的数据包括 PWD 的特征、照顾者的特征、与 PWD 的关系以及对照顾者的社会支持。照顾者负担用 Zarit 负担访谈量表进行测量。使用线性混合模型检查每个预测变量与照护费用和照顾者负担评分之间的关联。
发现照护费用的预测因素与照顾者负担的预测因素不同:Katz 日常生活活动(ADL)量表测量的功能下降与总费用相关,而神经精神问卷(NPI)测量的行为障碍与照护费用无关。然而,NPI 是照顾者负担的一个重要预测因素。经济状况较好的照顾者报告的照顾者负担也明显较低。
由于照护费用的预测因素与照顾者负担的预测因素不同,因此为照顾者提供针对 PWD 行为障碍的培训,并为低收入照顾者提供经济援助,可能有助于减轻照顾者负担。