School of Nursing, Naval Medical University, Shanghai, China.
Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China.
BMJ Open. 2022 May 24;12(5):e057817. doi: 10.1136/bmjopen-2021-057817.
To assess the level of caregiver burden and factors associated with it among family caregivers of persons with dementia (PWD) living in communities of Shanghai, China.
Cross-sectional study.
Communities in Hongkou District of Shanghai, China.
A random sample of 109 older adults with dementia and their primary family caregivers.
Caregiver burden measured by the Caregiver Burden Inventory (CBI), and the Caregivers' depressive symptom measured by the simplified Chinese version of Self-rating Depression Scale was the outcome variable of the study. The independent variables, including the cognitive function (measured by Montreal Cognitive Assessment (MoCA), sleep quality assessed by the Pittsburgh Sleep Quality Index, abilities of daily life assessed by the Activities of Daily Living Scale, and behavioural and psychological symptoms assessed by the Neuropsychiatric Inventory of PWDs, the community service utilisation (measured by the Community Service Utilisation Measurement), perceived social support (assessed by three questions), positive aspects of caregiving (PAC) (assessed by the PAC) of dementia caregivers, were analysed. Multivariate linear regression was employed to determine the factors related to caregiver burden.
The average level of CBI was 65.92±16.74. The score of MoCA, PAC and perceived social support of caregivers were negatively associated with caregiver burden (β=-0.84, p<0.001, β=-3.61, p=0.03 and β=-1.22, p=0.001, respectively). Community service utilisation was positively associated (β=3.46, p<0.001) with caregiver burden. Perceived social support by the caregiver moderated the relationship between caregiver burden and caregivers' depression symptoms.
Dementia caregivers experienced a high level of caregiver burden. The cognitive function of PWD, PAC, social support and community service utilisation were factors associated with caregiver burden. Strengthening social support, providing more high-quality home care services, promoting PAC are imperative to reduce caregiver burden.
评估中国上海社区中痴呆患者(PWD)家庭成员照顾者的负担水平及其相关因素。
横断面研究。
中国上海市虹口区社区。
随机抽取的 109 名痴呆症患者及其主要家庭成员照顾者。
照顾者负担采用照顾者负担量表(CBI)评估,照顾者抑郁症状采用简易中文版抑郁自评量表评估。认知功能(采用蒙特利尔认知评估量表评估)、睡眠质量(采用匹兹堡睡眠质量指数评估)、日常生活能力(采用日常生活能力量表评估)、行为和心理症状(采用神经精神疾病痴呆患者评定量表评估)、社区服务利用(采用社区服务利用测量评估)、感知社会支持(采用三个问题评估)、照顾者积极方面(PAC)(采用 PAC 评估)是本研究的自变量。采用多元线性回归分析确定与照顾者负担相关的因素。
CBI 的平均得分为 65.92±16.74。照顾者的 MoCA、PAC 和感知社会支持得分与照顾者负担呈负相关(β=-0.84,p<0.001,β=-3.61,p=0.03 和β=-1.22,p=0.001)。社区服务利用与照顾者负担呈正相关(β=3.46,p<0.001)。照顾者的感知社会支持调节了照顾者负担与照顾者抑郁症状之间的关系。
痴呆症照顾者负担水平较高。PWD 的认知功能、PAC、社会支持和社区服务利用是照顾者负担的相关因素。加强社会支持,提供更多高质量的家庭护理服务,促进 PAC,对于减轻照顾者负担至关重要。