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预测痴呆症患者感知到的社会支持的因素:一项混合方法研究。

Predictors of Perceived Social Support for Patients with Dementia: A Mixed-Methods Study.

机构信息

Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China.

School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People's Republic of China.

出版信息

Clin Interv Aging. 2020 Apr 30;15:595-607. doi: 10.2147/CIA.S249223. eCollection 2020.

Abstract

PURPOSE

Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression.

PATIENTS AND METHODS

Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models.

RESULTS

In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ=64.70, P<0.001). The mild group PSS was predicted by depression (β=-0.07, P=0.04), cognitive capacity (β=-0.18, P<0.001), and instrumental ability (β=-0.78, P<0.001), which differed from the moderate and severe groups.

CONCLUSION

This study provided comprehensive insight into PSS from PWDs' perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.

摘要

目的

感知到的社会支持(PSS)与痴呆症患者的健康结果密切相关。然而,其持续的益处尚不清楚。本混合方法研究考察了在疾病进展过程中患者和照顾者感知到的社会支持及其差异的影响。

患者和方法

从 9 个社区卫生中心招募了痴呆症患者(PWDs)、家庭照顾者和社区家庭医生。对 12 名 PWDs(7 名轻度痴呆症患者和 5 名中度痴呆症患者)、12 名家庭照顾者和 6 名社区家庭医生进行了半结构化访谈,并进行了常规内容分析,以探讨不同痴呆症阶段的社会支持观点。共有 470 名 PWDs 分为轻度(n=224)、中度(n=190)和重度(n=56)组。使用多元回归分析检查与 PSS 相关的人口统计学、身体和心理因素。将基于组的特征输入到三个预测模型中。

结果

在定性研究中,确定了三个社会支持主题:两个观点是关于社会支持的;每个阶段的不同需求和偏好;非个性化的支持服务。定量分析中,轻度组感知到的社会支持最低,而重度组最高(χ=64.70,P<0.001)。轻度组的 PSS 由抑郁(β=-0.07,P=0.04)、认知能力(β=-0.18,P<0.001)和工具能力(β=-0.78,P<0.001)预测,这与中度和重度组不同。

结论

本研究从疾病不同阶段的 PWDs 角度提供了对 PSS 的全面了解。结果表明需要采用分层护理方法,并为进一步的干预研究提供了方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/388b/7201008/59489652f22b/CIA-15-595-g0001.jpg

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