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因照顾者负担而搬入辅助生活设施与重新安置调整感知决策控制的中介作用。

Perceived Decisional Control as a Mediator between Moving to Assisted Living Due to Caregiver Burden and Relocation Adjustment.

机构信息

Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.

Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA.

出版信息

Clin Gerontol. 2022 Oct-Dec;45(5):1144-1154. doi: 10.1080/07317115.2020.1869132. Epub 2021 Jan 15.

Abstract

OBJECTIVES

The rapid growth of the older population in the United States has led to increased utilization of assisted living facilities (ALFs), and it is important to understand what factors may facilitate better adjustment. This study examined the mediating role of perceived decisional control in the relationship between moving to assisted living (AL) to prevent/alleviate caregiver burden and post-relocation adjustment.

METHODS

Participants were 91 newly-transitioned residents of ALFs in Alabama and Maryland. Data were gathered through in-person interviews and questionnaires. Mediation analyses were done using the PROCESS macro for SPSS, applying 5,000 bootstrap resamples with 95% bias-corrected confidence intervals estimated around the indirect effect.

RESULTS

The effect of moving to AL to prevent/alleviate caregiver burden on post-relocation depression and socialization was indirect and dependent on the degree of perceived decisional control.

CONCLUSIONS

Perceived decisional control may be a key factor in adjusting to AL, even when the move is catalyzed by such a complex and emotionally laden construct as caregiver burden.

CLINICAL IMPLICATIONS

Greater perceived decisional control over potential relocation may facilitate better adjustment, and other parties involved in the decision-making process should strive to involve the older adult in question in this process to the greatest extent possible.

摘要

目的

美国老年人口的快速增长导致辅助生活设施(ALF)的利用率增加,因此了解哪些因素可能有助于更好地调整非常重要。本研究考察了在向辅助生活(AL)过渡以预防/减轻照顾者负担与重新安置后的调整之间,感知决策控制在其中的中介作用。

方法

参与者是来自阿拉巴马州和马里兰州的 91 名新入住辅助生活设施的居民。通过面对面访谈和问卷调查收集数据。使用 SPSS 的 PROCESS 宏进行中介分析,应用 5000 次自举重采样,以 95%的偏差校正置信区间估计间接效应。

结果

为预防/减轻照顾者负担而搬入 AL 对重新安置后的抑郁和社交的影响是间接的,取决于感知决策控制的程度。

结论

感知决策控制可能是适应辅助生活的关键因素,即使搬迁是由照顾者负担等复杂且情感因素引发的。

临床意义

对潜在搬迁的感知决策控制越大,可能会促进更好的调整,参与决策过程的其他各方应努力让有关老年人尽可能多地参与这一过程。

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