澳大利亚痴呆症照顾者睡眠中断及其相关因素的横断面研究。
Disrupted sleep and associated factors in Australian dementia caregivers: a cross-sectional study.
机构信息
School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
School of Arts and Humanities (Psychological Services Centre), Edith Cowan University, Joondalup, Australia.
出版信息
BMC Geriatr. 2020 Aug 27;20(1):312. doi: 10.1186/s12877-020-01726-1.
BACKGROUND
Sleep disturbance is an issue reported by caregivers. Waking at night is a feature of dementia and by proxy, sleep disturbance among caregivers is reported to be high. Little is known about the characteristics of dementia caregivers' sleep and the factors that may influence sleep disruption. The purpose of this study was to investigate the sleep characteristics and disturbances of Australian caregivers of a person living with dementia. In addition, it evaluated the psychological wellbeing of caregivers by evaluating associations between mood and sleep in this population.
METHODS
This study used a cross-sectional, descriptive, correlation design. Participants were recruited with the assistance of Alzheimer's Australia, Dementia Australia and targeted social media advertising. In total, 104 adult, primary, informal caregivers of people with dementia participated, completing a questionnaire on demographic characteristics, the Depression, Anxiety and Stress Scale (DASS-21) and the Pittsburgh Sleep Quality Index (PSQI).
RESULTS
In this study, 76% of caregivers were female who had been caring for someone living with dementia on average for 4.8 years. 44% of participants had two or more co-morbidities namely cardiovascular disease, osteoarthritis and diabetes. 94% of participants were poor sleepers with 84% with difficulty initiating sleep and 72% reporting having difficulty maintaining sleep. Overall, psychological distress was common with high levels of moderate to severe depression, anxiety and stress. Global PSQI scores were significantly positively associated with depression and anxiety, with the strongest correlation seen with stress scores. Depression scores were also moderately associated with daytime dysfunction. Stress was identified as a significant predictor of overall sleep quality.
CONCLUSIONS
Sleep problems are common within the population of dementia caregivers. Due to the nature and duration of caregiving and the progression of dementia of the care recipient, there is the potential for a decline in the caregivers' mental and physical health. Caregivers of those living with dementia are more likely to have comorbidities, depression, anxiety and stress. Sleep quality is correlated with emotional distress in dementia caregivers although the direction of this association is unclear. Therefore, sleep and psychological wellbeing may be intertwined, with improvements in one aspect resulting in a positive impact in the other.
背景
睡眠障碍是照料者报告的一个问题。夜间醒来是痴呆症的一个特征，因此，照料者的睡眠障碍据报道也很高。人们对痴呆症照料者的睡眠特征和睡眠障碍知之甚少，也不知道哪些因素可能会影响睡眠中断。本研究旨在调查澳大利亚痴呆症患者照料者的睡眠特征和睡眠障碍。此外，通过评估该人群的情绪与睡眠之间的关联，评估照料者的心理健康状况。
方法
本研究采用了横断面、描述性、相关性设计。在 Alzheimer's Australia、Dementia Australia 和有针对性的社交媒体广告的协助下招募参与者。共有 104 名成年、主要的、非正式的痴呆症患者照料者参与了这项研究，他们完成了一份关于人口统计学特征、抑郁、焦虑和压力量表（DASS-21）和匹兹堡睡眠质量指数（PSQI）的问卷。
结果
在这项研究中，76%的照料者是女性，平均照顾患有痴呆症的人 4.8 年。44%的参与者有两种或两种以上的合并症，即心血管疾病、骨关节炎和糖尿病。94%的参与者睡眠质量差，84%的人入睡困难，72%的人报告难以维持睡眠。总的来说，心理困扰很常见，有中度至重度抑郁、焦虑和压力的人很多。总体 PSQI 评分与抑郁和焦虑显著正相关，与压力评分的相关性最强。抑郁评分与日间功能障碍也有中度相关。压力被确定为整体睡眠质量的一个重要预测因素。
结论
睡眠问题在痴呆症照料者中很常见。由于照顾的性质和持续时间以及被照顾者痴呆症的进展，照料者的身心健康有可能下降。痴呆症患者的照料者更有可能患有合并症、抑郁、焦虑和压力。痴呆症照料者的睡眠质量与情绪困扰相关，尽管这种关联的方向尚不清楚。因此，睡眠和心理健康可能相互交织，一方面的改善会对另一方面产生积极影响。
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