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智利痴呆老年人群中未满足需求的预测因素:一项横断面研究。

Predictors of unmet needs in Chilean older people with dementia: a cross-sectional study.

机构信息

Mailman School of Public Health, Columbia University, New York, USA.

Gerosciences Center for Brain Health and Metabolism (GERO), Santiago, Chile.

出版信息

BMC Geriatr. 2019 Apr 15;19(1):106. doi: 10.1186/s12877-019-1131-1.

Abstract

BACKGROUND

The needs of people with dementia (PWD) have not been assessed in any Latin American country. Several European countries have already related unmet needs with quality of life, caregiver's age, burden, stress, anxiety and depression. The aim of this study was to identify met and unmet needs in Chilean older adults with dementia and to determine if those needs were associated with PWD's, their informal caregivers' and social factors.

METHOD

This was a cross-sectional study. One-hundred and sixty-six informal caregivers and their care recipients were interviewed. PWD was assessed about cognitive function and their caregivers answered instruments about PWD's needs, functional status and behavioral and psychological symptoms. Caregiver's burden, depression, anxiety and social support were also evaluated. A stepwise multiple linear regression analysis was performed to determine predictors of unmet needs in Chilean PWD.

RESULTS

The most frequent met needs were "Looking after home" (81.3%%), "Food" (78.9%) and "Selfcare" (75.3%). Most common unmet needs were "Daily living activities" (39.2%), "Company" (36.1%), and "Memory" (34.9%). Caregivers' lower age was correlated to a higher number of PWD's unmet needs (r = -.216; p < 0.005). Higher PWD's dependence was associated with higher number of unmet needs (r = .177; p < 0.05). The best predictors of unmet needs were caregivers' low level of social support, high burden, young age and high level of anxiety.

CONCLUSION

It is necessary to address psychological and social needs of PWD. The fact that PWD's unmet needs were associated mostly with caregivers' factors, highlights the importance of considering both, the PWD and their informal caregivers as targets of institutional support. It is expected that recently launched national public policies decrease PWD's unmet needs by the provision of new services for them and their informal caregivers.

摘要

背景

拉丁美洲国家尚未对痴呆症患者(PWD)的需求进行评估。几个欧洲国家已经将未满足的需求与生活质量、照顾者的年龄、负担、压力、焦虑和抑郁联系起来。本研究的目的是确定智利痴呆症老年人的已满足和未满足的需求,并确定这些需求是否与 PWD、他们的非正式照顾者和社会因素有关。

方法

这是一项横断面研究。对 166 名非正式照顾者及其照顾对象进行了访谈。评估了 PWD 的认知功能,他们的照顾者回答了关于 PWD 的需求、功能状态以及行为和心理症状的工具。还评估了照顾者的负担、抑郁、焦虑和社会支持。进行了逐步多元线性回归分析,以确定智利 PWD 未满足需求的预测因素。

结果

最常见的已满足需求是“照顾家庭”(81.3%)、“食物”(78.9%)和“自我护理”(75.3%)。最常见的未满足需求是“日常生活活动”(39.2%)、“陪伴”(36.1%)和“记忆”(34.9%)。照顾者的年龄较小与 PWD 未满足需求的数量较多相关(r = -.216;p < 0.005)。PWD 的依赖性越高,未满足的需求就越多(r = .177;p < 0.05)。未满足需求的最佳预测因素是照顾者的社会支持水平低、负担重、年龄小和焦虑水平高。

结论

有必要满足 PWD 的心理和社会需求。事实上,PWD 的未满足需求主要与照顾者的因素有关,这凸显了考虑 PWD 及其非正式照顾者作为机构支持目标的重要性。预计最近推出的国家公共政策将通过为他们和他们的非正式照顾者提供新的服务来减少 PWD 的未满足需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f6c/6466805/92617d7e33b1/12877_2019_1131_Fig1_HTML.jpg

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