Department of Neurology, Layton Aging & Alzheimer's Disease Center,Oregon Health & Science University,Portland, OR,USA.
William F. Connell School of Nursing,Boston College,Chestnut Hill, MA,USA.
Int Psychogeriatr. 2019 May;31(5):617-626. doi: 10.1017/S104161021800203X. Epub 2019 Feb 6.
ABSTRACTBackground and Purpose:The impact of dementia-related stressors and strains have been examined for their potential to threaten the well-being of either the person with dementia or the family care partner, but rarely have studies considered the dyadic nature of well-being in dementia. The purpose of this study was to examine the dyadic effects of multiple dimensions of strain on the well-being of dementia care dyads.
Using multilevel modeling to account for the inter-relatedness of individual well-being within dementia care dyads, we examined cross-sectional responses collected from 42 dyads comprised of a hospitalized patient diagnosed with a primary progressive dementia (PWD) and their family care partner (CP). Both PWDs and CPs self-reported on their own well-being using measures of quality of life (QOL-Alzheimer's Disease scale) and depressive symptoms (Center for Epidemiological Studies Depression Scale).
In adjusted models, the PWD's well-being (higher QOL and lower depressive symptoms) was associated with significantly less strain in the dyad's relationship. The CP's well-being was associated with significantly less care-related strain and (for QOL scale) less relationship strain.
Understanding the impact of dementia on the well-being of PWDs or CPs may require an assessment of both members of the dementia care dyad in order to gain a complete picture of how dementia-related stressors and strains impact individual well-being. These results underscore the need to assess and manage dementia-related strain as a multi-dimensional construct that may include strain related to the progression of the disease, strain from providing care, and strain on the dyad's relationship quality.
摘要
痴呆相关压力源和紧张源对痴呆患者或家庭护理伴侣的幸福感的潜在威胁已经过研究,但很少有研究考虑到痴呆症中幸福感的双重性质。本研究的目的是研究多种紧张源维度对痴呆症护理双重体幸福感的双重影响。
使用多层次模型来解释痴呆症护理双重体中个体幸福感的相互关联性,我们检查了来自 42 对由患有原发性进行性痴呆症(PWD)的住院患者及其家庭护理伴侣(CP)组成的双重体的横断面反应。PWD 和 CP 均使用生活质量(阿尔茨海默病量表)和抑郁症状(流行病学研究抑郁量表)的指标报告自己的幸福感。
在调整后的模型中,PWD 的幸福感(更高的生活质量和更低的抑郁症状)与双重体关系中的紧张程度显著降低有关。CP 的幸福感与护理相关的紧张程度显著降低(对于生活质量量表)和关系紧张程度降低有关。
理解痴呆对 PWD 或 CP 幸福感的影响可能需要对痴呆症护理双重体的两个成员进行评估,以全面了解痴呆相关压力源和紧张源如何影响个体幸福感。这些结果强调了需要评估和管理与痴呆相关的紧张源作为一个多维结构,该结构可能包括与疾病进展相关的紧张源、提供护理的紧张源以及双重体关系质量的紧张源。