Safavi Roxanne, Wearden Alison, Berry Katherine
Division of Psychology and Mental Health.
Fam Syst Health. 2019 Sep;37(3):249-254. doi: 10.1037/fsh0000426. Epub 2019 Jun 6.
Carers of persons with dementia (PWD) experience high levels of burden and distress and may use criticism in an attempt to change the behavior of PWD and thereby reduce their distress. We hypothesized that carer distress and criticism would each have an impact on the psychological well-being of the PWD and examined whether criticism mediates the association between carer distress and PWD psychological well-being.
We recruited 61 persons with a recent diagnosis of dementia and their carer via U.K. dementia services and assessed at 2 time points 6 months apart. Carers completed questionnaire measures of burden and distress. We coded critical comments from a Camberwell Family Interview. PWD completed questionnaire measures of quality of life, depression, and anxiety. We conducted correlation, regression, and mediation analyses to explore the relationship between carer variables and PWD psychological outcomes and whether criticism mediated any relationship found.
Carer distress, carer critical comments, and PWD anxiety and depression at 6-month follow-up were all significantly correlated. Baseline carer distress predicted poorer quality of life in PWD at 6-month follow-up. The number of carer critical comments significantly ( < .01) mediated the effect of carer distress on PWD quality of life.
Interventions addressing carer burden and distress and offering coping strategies to help them to reduce criticism of the PWD would improve the quality of life of those affected by dementia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
痴呆症患者(PWD)的照料者承受着高水平的负担和痛苦,可能会使用批评的方式来试图改变痴呆症患者的行为,从而减轻自己的痛苦。我们假设照料者的痛苦和批评都会对痴呆症患者的心理健康产生影响,并研究批评是否在照料者痛苦与痴呆症患者心理健康之间起中介作用。
我们通过英国的痴呆症服务机构招募了61名近期被诊断为痴呆症的患者及其照料者,并在相隔6个月的两个时间点进行评估。照料者完成了关于负担和痛苦的问卷调查。我们对来自坎伯韦尔家庭访谈中的批评性评论进行编码。痴呆症患者完成了关于生活质量、抑郁和焦虑的问卷调查。我们进行了相关性、回归和中介分析,以探讨照料者变量与痴呆症患者心理结果之间的关系,以及批评是否介导了所发现的任何关系。
在6个月的随访中,照料者的痛苦、照料者的批评性评论以及痴呆症患者的焦虑和抑郁均显著相关。基线时照料者的痛苦预测了6个月随访时痴呆症患者较差的生活质量。照料者批评性评论的数量显著(<.01)介导了照料者痛苦对痴呆症患者生活质量的影响。
针对照料者负担和痛苦的干预措施,以及提供应对策略以帮助他们减少对痴呆症患者的批评,将改善受痴呆症影响者的生活质量。(PsycINFO数据库记录(c)2019美国心理学会,保留所有权利)