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认知障碍老年人的非正式照护者在住房决策时的决策后悔:一项横断面分析。

Decision Regret among Informal Caregivers Making Housing Decisions for Older Adults with Cognitive Impairment: A Cross-sectional Analysis.

机构信息

VITAM - Centre de recherche en santé durable, Quebec, QC, Canada.

Canada Research Chair in Shared Decision Making and Knowledge Translation (Tier 1) and Population Health and Practice-Changing Research Group, VITAM - Centre de recherche en santé durable, Quebec, QC, Canada.

出版信息

Med Decis Making. 2020 May;40(4):416-427. doi: 10.1177/0272989X20925368. Epub 2020 Jun 10.

Abstract

. Informal caregivers are regularly faced with difficult housing decisions for older adults with cognitive impairment. They often regret the decision they made. We aimed to identify factors associated with decision regret among informal caregivers engaging in housing decisions for cognitively impaired older adults. . We performed a secondary analysis of cross-sectional data collected from a cluster-randomized trial. Eligible participants were informal caregivers involved in making housing decisions for cognitively impaired older adults. Decision regret was assessed after caregivers' enrollment in the study using the Decision Regret Scale (DRS), scored from 0 to 100. We used a conceptual framework of potential predictors of regret to identify independent variables. We performed multilevel analyses using a mixed linear model by estimating fixed effects (β) and 95% confidence intervals (CIs). . The mean (SD) DRS score of 296 informal caregivers (mean [SD] age, 62 [12] years) was 12.4 (18.4). Factors associated with less decision regret were having a college degree compared to primary education (β [95% CI]: -11.14 [-18.36, -3.92]), being married compared to being single (-5.60 [-10.05, -1.15]), informal caregivers' perception that a joint process occurred (-0.14 [-0.25, -0.02]), and older adults' not having a specific housing preference compared to preferring to stay at home (-4.13 [-7.40, -0.86]). Factors associated with more decision regret were being retired compared to being a homemaker (7.74 [1.32, 14.16]), higher burden of care (0.14 [0.05, 0.22]), and higher decisional conflict (0.51 [0.34, 0.67]). . Our analysis may not illustrate all predictors of decision regret among informal caregivers. . Our findings will allow risk-mitigation strategies for informal caregivers at risk of experiencing regret.

摘要

. 非专业照护者经常面临为认知障碍老年人做出困难的住房决策。他们经常对自己做出的决策感到后悔。我们旨在确定与参与认知障碍老年人住房决策的非专业照护者的决策后悔相关的因素。. 我们对一项基于聚类随机试验的横断面数据进行了二次分析。合格的参与者是非专业照护者,他们参与了认知障碍老年人的住房决策。在研究入组后,使用决策后悔量表(DRS)评估照护者的决策后悔程度,得分范围为 0 至 100。我们使用一个潜在后悔预测因素的概念框架来确定自变量。我们使用混合线性模型通过估计固定效应(β)和 95%置信区间(CI)进行多层次分析。. 296 名非专业照护者(平均[标准差]年龄,62[12]岁)的 DRS 平均(SD)得分为 12.4(18.4)。与决策后悔程度较低相关的因素是,与小学教育相比,拥有大学学历(β[95%CI]:-11.14[-18.36,-3.92]),已婚状态而非单身状态(-5.60[-10.05,-1.15]),非专业照护者认为共同决策过程发生(-0.14[-0.25,-0.02]),以及老年人没有特定的住房偏好,而不是更喜欢留在家里(-4.13[-7.40,-0.86])。与决策后悔程度较高相关的因素是与家庭主妇相比,退休状态(7.74[1.32,14.16]),更高的照护负担(0.14[0.05,0.22]),以及更高的决策冲突(0.51[0.34,0.67])。. 我们的分析可能无法说明非专业照护者决策后悔的所有预测因素。. 我们的研究结果将为有后悔风险的非专业照护者提供风险缓解策略。

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