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痴呆症患者护理的情感体验:家庭护理者叙事背后的内疚感和矛盾情绪。

The emotional experience of caregiving in dementia: Feelings of guilt and ambivalence underlying narratives of family caregivers.

机构信息

Department of Dynamic and Clinical Psychology, 9311Sapienza University of Rome, Rome, Italy.

出版信息

Dementia (London). 2021 Oct;20(7):2248-2260. doi: 10.1177/1471301221989604. Epub 2021 Feb 3.

DOI:10.1177/1471301221989604
PMID:33530724
Abstract

OBJECTIVE

The aim of this study was to explore narrative domains of family caregivers' emotional experiences, beyond intentional and explicitly reported contents, and to examine their associations with subjects defining characteristics, such as gender, kinship, duration of caregiving, and burden levels.

METHODS

The study participants were 17 Italian family caregivers (88.23% women) with a mean age of 59.14 years ( = 7.76), who provided their loved ones affected by dementia with in-home care. Structured interviews and Caregiver Burden Inventory were administered according to a mixed method design. A computer-aided text analysis was used which allowed the detection of shared narrative domains (cluster analysis) and latent factors organizing the contraposition between them (multiple correspondence analysis).

FINDINGS

Five narrative domains emerged which were respectively referred to as perceived formal support (14.38% of the overall textual corpus), devotion (33.56%), anger (13.70%), sense of loss (18.49%), and feeling of uncertainty (19.86%). Kinship, duration of caregiving, and burden levels were differently associated with such domains. Two latent factors dealing with feelings of guilt and ambivalence explained 62.92% of overall data variance.

CONCLUSION

Guilt feelings should be carefully taken into account in support intervention with caregivers, with specific regard to stress and anger management. As well, a greater focus on caregivers' emotion regulation and on the promotion of their problem-solving skills is needed when faced with contrasting beliefs about care decisions or role conflicts.

摘要

目的

本研究旨在探索家庭照顾者情感体验的叙述领域,超越有意和明确报告的内容,并研究其与主体定义特征(如性别、亲属关系、照顾时间和负担水平)的关联。

方法

研究参与者为 17 名意大利家庭照顾者(88.23%为女性),平均年龄为 59.14 岁(=7.76),他们为家中受痴呆症影响的亲人提供护理。根据混合方法设计,进行了结构化访谈和照顾者负担量表评估。采用计算机辅助文本分析,检测共享叙述领域(聚类分析)和组织它们之间对立的潜在因素(多重对应分析)。

结果

出现了五个叙述领域,分别是感知的正式支持(总体文本的 14.38%)、奉献(33.56%)、愤怒(13.70%)、失落感(18.49%)和不确定性感(19.86%)。亲属关系、照顾时间和负担水平与这些领域有不同的关联。两个涉及内疚感和矛盾情绪的潜在因素解释了总数据方差的 62.92%。

结论

在对照顾者的支持干预中,应仔细考虑内疚感,特别是在压力和愤怒管理方面。在面对关于护理决策或角色冲突的矛盾信念时,还需要更加关注照顾者的情绪调节和解决问题的能力培养。

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