Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany.
Competence Centre for Clinical Trials, University of Bremen and Clinic Bremen-Mitte, Bremen, Germany.
BMC Health Serv Res. 2021 Jul 23;21(1):727. doi: 10.1186/s12913-021-06708-6.
Studies revealed the importance to assess dementia care dyads, composed of persons with dementia and their primary informal caregivers, in a differentiated way and to tailor support services to particular living and care circumstances. Therefore, this study aims first to identify classes of dementia care dyads that differ according to sociodemographic, care-related and dementia-specific characteristics and second, to compare these classes with regard to healthcare-related outcomes.
We used data from the cross-sectional German DemNet-D study (n = 551) and conducted a latent class analysis to investigate different classes of dementia care dyads. In addition, we compared these classes with regard to the use of health care services, caregiver burden (BIZA-D), general health of the informal caregiver (EQ-VAS) as well as quality of life (QoL-AD) and social participation (SACA) of the person with dementia. Furthermore, we compared the stability of the home-based care arrangements.
Six different classes of dementia care dyads were identified, based on best Bayesian Information Criterion (BIC), significant likelihood ratio test (p < 0.001), high entropy (0.87) and substantive interpretability. Classes were labelled as "adult child parent relationship & younger informal caregiver", "adult child parent relationship & middle aged informal caregiver", "non family relationship & younger informal caregiver", "couple & male informal caregiver of older age", "couple & female informal caregiver of older age", "couple & younger informal caregiver". The classes showed significant differences regarding health care service use. Caregiver burden, quality of life of the person with dementia and stability of the care arrangement differed also significantly between the classes.
Based on a latent class analysis this study indicates differences between classes of informal dementia care dyads. The findings may give direction for better tailoring of support services to particular circumstances to improve healthcare-related outcomes of persons with dementia and informal caregivers.
研究表明，以差异化的方式评估由痴呆症患者及其主要非正规照护者组成的痴呆症照护对，并根据特定的生活和照护情况调整支持服务非常重要。因此，本研究旨在首先确定根据社会人口统计学、照护相关和痴呆症特定特征而有所不同的痴呆症照护对的类别，其次比较这些类别在医疗保健相关结果方面的差异。
我们使用了来自横断面德国 DemNet-D 研究（n=551）的数据，并进行了潜在类别分析，以调查不同的痴呆症照护对类别。此外，我们还比较了这些类别在使用医疗保健服务、照护者负担（BIZA-D）、非正规照护者的一般健康状况（EQ-VAS）以及痴呆症患者的生活质量（QoL-AD）和社会参与（SACA）方面的差异。此外，我们还比较了居家照护安排的稳定性。
基于最佳贝叶斯信息准则（BIC）、显著似然比检验（p<0.001）、高熵值（0.87）和实质性可解释性，确定了六个不同的痴呆症照护对类别。类别被标记为“成年子女与父母关系和年轻的非正规照护者”、“成年子女与父母关系和中年非正规照护者”、“非家庭关系和年轻的非正规照护者”、“夫妻与老年男性非正规照护者”、“夫妻与老年女性非正规照护者”和“夫妻与年轻的非正规照护者”。这些类别在医疗保健服务使用方面存在显著差异。照护者负担、痴呆症患者的生活质量和照护安排的稳定性在类别之间也存在显著差异。
基于潜在类别分析，本研究表明非正规痴呆症照护对的类别存在差异。这些发现可能为更好地根据特定情况调整支持服务提供方向，以改善痴呆症患者和非正规照护者的医疗保健相关结果。
