Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
Int J Geriatr Psychiatry. 2021 Feb;36(2):360-367. doi: 10.1002/gps.5433. Epub 2020 Sep 25.
Sense of coherence (SOC) is increasingly recognized as an important health determinant, particularly for mental health. Part of the evidence comes from informal caregivers in diverse clinical conditions. The extent to which SOC influences caregiving outcomes, however, is relatively under-researched in dementia, particularly regarding positive experiences. We analysed the association of SOC with dementia caregivers' subjective burden, psychological distress and positive aspects of care.
METHODS/DESIGN: This is a secondary analysis of cross-sectional data from the Lisbon study of Families of Persons with Dementia, involving a convenience sample of 99 primary caregivers of community-dwelling patients of neurology and psychiatry services. SOC was assessed with the Orientation for Life Scale. Measures of caregivers' outcomes were: the Zarit Burden Interview, the General Health Questionnaire for psychological distress and the Positive Aspects of Caregiving scale. Analyses controlled for demographics, caregiving arrangements, objective burden, social support, patients' neuropsychiatric symptoms and dementia stage.
Lower SOC was associated with higher psychological distress (p = 0.001). No significant associations were found for subjective burden (p = 0.081) or positive aspects of caregiving (p = 0.688). Additional analyses showed that lower SOC was associated with less emotional support (p < 0.001) and past psychiatric illness (p = 0.044).
These findings support previous research suggesting that SOC is protective for psychological distress, and extend evidence to the positive aspects of care in dementia. The cross-sectional design and small-scale convenience sampling preclude both causality presumptions and generalizability. SOC assessments may be useful to define subgroups of dementia caregivers at risk for anxiety and depression.
越来越多的人认识到，社会感（SOC）是一个重要的健康决定因素，尤其是对心理健康而言。这些证据部分来自不同临床环境下的非专业照护者。然而，SOC 对痴呆症患者照护结果的影响程度，尤其是对积极体验的影响程度，在研究中相对较少。我们分析了 SOC 与痴呆症照护者主观负担、心理困扰和积极照护方面的关系。
方法/设计：这是里斯本家庭痴呆症患者研究的横断面数据的二次分析，涉及神经病学和精神病学服务的社区居住患者的 99 名初级照护者的便利样本。SOC 采用生活方向量表进行评估。照护者结局的测量包括：Zarit 负担量表、一般健康问卷心理困扰量表和积极照护量表。分析控制了人口统计学、照护安排、客观负担、社会支持、患者的神经精神症状和痴呆阶段。
较低的 SOC 与较高的心理困扰相关（p = 0.001）。主观负担（p = 0.081）或积极的照护方面（p = 0.688）没有显著相关性。进一步分析表明，较低的 SOC 与较少的情感支持（p < 0.001）和过去的精神病史（p = 0.044）相关。
这些发现支持了之前的研究，表明 SOC 对心理困扰具有保护作用，并将证据扩展到痴呆症的积极照护方面。横断面设计和小规模的便利抽样排除了因果关系的假设和普遍性。SOC 评估可能有助于确定有焦虑和抑郁风险的痴呆症照护者亚组。
