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解析英国大量痴呆症照料者的照料负担:情境因素、行为问题、心理复原力和预期性悲伤的作用。

Explaining caregiver burden in a large sample of UK dementia caregivers: The role of contextual factors, behavioural problems, psychological resilience, and anticipatory grief.

作者信息

Gilsenan Jane, Gorman Colin, Shevlin Mark

机构信息

School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland.

出版信息

Aging Ment Health. 2023 Jul-Aug;27(7):1274-1281. doi: 10.1080/13607863.2022.2102138. Epub 2022 Jul 26.

Abstract

OBJECTIVES

Dementia caregiver burden is a significant public health concern, affecting both the wellbeing of caregivers and their care-recipients. This study investigated a range of variables associated with caregiver burden in a large sample of UK dementia caregivers. Clinical characteristics and novel psychological constructs were used - including anticipatory grief and psychological resilience. Anticipatory grief refers to the process of experiencing loss prior to the death of a significant person.

METHOD

Caregivers of persons with dementia ( = 530) completed a survey obtaining the Zarit-Burden Interview (ZBI-SF) and other psychological and demographic/caregiving-related factors.

RESULTS

Findings illustrate that 71% of the sample experienced high levels of caregiver burden and around 95% met the criteria for clinically significant levels of burden. A regression model explained 49% of the variance in subjective caregiver burden; contextual factors (care-recipients living situation, frequency of caregiving), behavioural challenges in the care-recipient (memory-related problem behaviours), caregiver psychological resilience and caregiver anticipatory grief (heartfelt long & sadness, worry & felt isolation) were all significant variables. Caregiver anticipatory grief, followed by psychological resilience, had the strongest association with burden.

CONCLUSION

Caregiver anticipatory grief and psychological resilience, have a significant interaction with the clinical presentation of the dementia sufferer in explaining subjective caregiver burden. More grief and resilience-focused interventions targeting both the practical and emotional challenges are imperative to reduce burden and thus to ensure caregiver wellbeing.

摘要

目标

痴呆症照料者负担是一个重大的公共卫生问题,影响着照料者及其照料对象的福祉。本研究调查了英国大量痴呆症照料者样本中一系列与照料者负担相关的变量。使用了临床特征和新的心理结构——包括预期性悲伤和心理复原力。预期性悲伤是指在重要人物去世之前经历丧失的过程。

方法

530名痴呆症患者的照料者完成了一项调查,获取了 Zarit 负担访谈简版(ZBI-SF)以及其他心理和人口统计学/照料相关因素。

结果

研究结果表明,71%的样本经历了高水平的照料者负担,约95%符合临床上显著负担水平的标准。一个回归模型解释了主观照料者负担中49%的方差;背景因素(照料对象的生活状况、照料频率)、照料对象的行为挑战(与记忆相关的问题行为)、照料者的心理复原力和照料者的预期性悲伤(深切的长久悲伤、担忧和感到孤独)都是显著变量。照料者的预期性悲伤,其次是心理复原力,与负担的关联最强。

结论

照料者的预期性悲伤和心理复原力在解释主观照料者负担方面与痴呆症患者的临床表现有显著相互作用。必须针对实际和情感挑战开展更多以悲伤和复原力为重点的干预措施,以减轻负担,从而确保照料者的福祉。

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