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照顾者抑郁与老年人虐待之间的关联——探究受照顾者神经精神症状和照顾者感知负担的调节作用。

Association Between Caregiver Depression and Elder Mistreatment-Examining the Moderating Effect of Care Recipient Neuropsychiatric Symptoms and Caregiver-Perceived Burden.

作者信息

Fang Boye, Liu Huiying, Yan Elsie

机构信息

School of Sociology & Anthropology, Sun Yat-sen University, Guangdong Province, China.

Department of Sociology, Central South University, Changsha, Hunan Province, China.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2021 Nov 15;76(10):2098-2111. doi: 10.1093/geronb/gbab025.

DOI:10.1093/geronb/gbab025
PMID:33598710
Abstract

OBJECTIVES

To examine the association between caregiver (CG) depression and increase in elder mistreatment and to investigate whether change in care recipient (CR) neuropsychiatric symptoms (NPS) and change in CG-perceived burden influence this association.

METHODS

Using 2-year longitudinal data, we analyzed a consecutive sample of 800 Chinese primary family CGs and their CRs with mild cognitive impairment or mild-to-moderate dementia recruited from the geriatric and neurological departments of 3 Grade-A hospitals in the People's Republic of China. Participatory dyads were assessed between September 2015 and February 2016 and followed for 2 years.

RESULTS

CG depression at baseline was associated with a sharper increase in psychological abuse and neglect. For CRs with increased NPS, having a depressed CG predicted a higher level of psychological abuse than for those CRs without NPS. For CGs with decreased burden, the level of depression was associated with a slower increase in neglect than for CGs who remained low burden.

DISCUSSION

This study showed the differential impact of CG depression on the increase in elder mistreatment depending on the change in CR NPS and CG-perceived burden. The present findings provide valuable insights into the design of a systematic and integrative intervention protocol for elder mistreatment that simultaneously focuses on treating CG depression and perceived burden and CR NPS.

摘要

目的

探讨照料者抑郁与老年人受虐待行为增加之间的关联,并研究受照料者神经精神症状(NPS)的变化以及照料者感知到的负担变化是否会影响这种关联。

方法

利用为期两年的纵向数据,我们分析了从中华人民共和国3家甲级医院的老年科和神经科招募的800名中国主要家庭照料者及其患有轻度认知障碍或轻度至中度痴呆的受照料者的连续样本。参与研究的二元组在2015年9月至2016年2月期间接受评估,并随访2年。

结果

基线时照料者抑郁与心理虐待和忽视行为的更急剧增加有关。对于NPS增加的受照料者,有抑郁的照料者比没有NPS的受照料者预测的心理虐待水平更高。对于负担减轻的照料者,与负担一直较轻的照料者相比,抑郁水平与忽视行为增加较慢有关。

讨论

本研究表明,照料者抑郁对老年人受虐待行为增加的影响因受照料者NPS的变化和照料者感知到的负担而异。目前的研究结果为设计一个系统的、综合的老年人受虐待干预方案提供了有价值的见解,该方案同时关注治疗照料者抑郁和感知到的负担以及受照料者的NPS。

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