Comprehensive Health Research Center (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.
Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.
Aging Ment Health. 2022 Nov;26(11):2307-2315. doi: 10.1080/13607863.2021.1969641. Epub 2021 Sep 6.
Relationship quality (RQ) between a person with dementia and a family carer may influence their health and quality of life. However, evidence regarding its course and influencing factors is limited. We aimed to explore RQ trajectories in dementia, and identify predictors of change.
We analysed longitudinal data from a cohort of 350 community-dwelling people with dementia and their informal carers, participating in the Actifcare study in eight European countries. The Positive Affect Index, rated separately by both people with dementia and their carers, assessed RQ. Other measures included the Neuropsychiatric Inventory Questionnaire (regarding persons with dementia), and the Relative Stress Scale, Sense of Coherence Scale and Lubben Social Network Scale (for carers). Trajectories and influencing factors were explored applying a latent growth model (LGM).
RQ in the group of carers declined over 1 year, but RQ scores for the persons with dementia did not change. Higher stress in carers negatively influenced their baseline RQ ratings. Carer sense of coherence and being a spouse were associated with more positive baseline RQ carer assessments. Higher levels of neuropsychiatric symptoms were linked to decline in carers' RQ, whereas social support was associated with more positive RQ trajectories.
This study provides a valuable insight into the course of RQ. LGM proved useful to explore the factors that influence RQ trajectories and variability within- and between-persons. Our findings emphasise the importance of carer-perceived social support and sense of coherence, and of reducing neuropsychiatric symptoms, in maintaining a good RQ.
痴呆症患者与其家庭照顾者之间的关系质量（RQ）可能会影响他们的健康和生活质量。然而，关于其发展轨迹和影响因素的证据有限。我们旨在探讨痴呆症患者 RQ 的发展轨迹，并确定变化的预测因素。
我们分析了来自 8 个欧洲国家参与 Actifcare 研究的 350 名居住在社区的痴呆症患者及其非专业照顾者的队列纵向数据。积极情感指数（Positive Affect Index）由痴呆症患者及其照顾者分别评定，用于评估 RQ。其他措施包括神经精神问卷（针对痴呆症患者）和相对压力量表、心理韧性量表、社会网络量表（针对照顾者）。轨迹和影响因素的研究采用潜在增长模型（LGM）。
照顾者组的 RQ 在 1 年内下降，但痴呆症患者的 RQ 评分没有变化。照顾者的压力较大，会对其基线 RQ 评分产生负面影响。照顾者的心理韧性和配偶身份与基线 RQ 照顾者评估的更积极有关。较高的神经精神症状水平与照顾者 RQ 的下降有关，而社会支持与 RQ 轨迹的更积极有关。
本研究深入了解了 RQ 的发展轨迹。LGM 证明在探索影响 RQ 轨迹的因素以及个体内和个体间的变异性方面是有用的。我们的研究结果强调了照顾者感知到的社会支持和心理韧性的重要性，以及减轻神经精神症状对维持良好 RQ 的重要性。
