验证终末期痴呆症照顾者角色负担和收益的衡量标准。
Validation of a Measure of Role Overload and Gains for End-of-Life Dementia Caregivers.
机构信息
School of Social and Behavioral Health, Oregon State University, Corvallis, Oregon, USA.
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
出版信息
J Gerontol B Psychol Sci Soc Sci. 2023 Mar 13;78(Suppl 1):S15-S26. doi: 10.1093/geronb/gbac145.
OBJECTIVES
Caregiving stress process models suggest that heterogeneous contexts differentially contribute to caregivers' experiences of role overload and gains. End-of-life (EOL) caregivers, especially EOL dementia caregivers, facing unique challenges and care tasks, may experience role overload and gains in different ways than other caregivers. This study evaluates measurement invariance of role overload and gains between EOL caregivers and non-EOL caregivers and between EOL dementia and EOL non-dementia caregivers.
METHODS
We utilized role gains and overload data from 1,859 family caregivers who participated in Round 7 of the National Study of Caregiving. We ran confirmatory factor analyses to investigate the factorial structure across all caregivers and then examined the structure's configural, metric, and scalar invariance between (a) EOL caregivers and non-EOL caregivers and (b) EOL dementia and EOL non-dementia caregivers.
RESULTS
Across the entire sample, the two-factor overload and gains model had good fit (χ 2(19) = 121.37, p < .0001; RMSEA = .053, 90% CI = [.044, .062]; CFI = .954; TLI = .932). Tests of invariance comparing EOL caregivers to non-EOL caregivers and EOL dementia caregivers to EOL non-dementia caregivers maintained configural, metric, and partial scalar invariance. Latent mean comparisons revealed that EOL caregivers had higher role overload (p = .0002), but no different role gains (p = .45), than non-EOL caregivers. Likewise, EOL dementia caregivers had higher role overload (p = .05), but no different role gains (p = .42), than EOL non-dementia caregivers.
DISCUSSION
Results offer both a deeper theoretical understanding of end-of-life dementia caregivers' experiences of role overload and gains, and a practical tool to measure those experiences.
目的
照护压力过程模型表明，不同的情境会对照护者的角色过载和获益体验产生不同的影响。临终（EOL）照护者，特别是 EOL 痴呆症照护者，面临着独特的挑战和护理任务，他们可能会以不同于其他照护者的方式体验角色过载和获益。本研究评估了 EOL 照护者和非 EOL 照护者以及 EOL 痴呆症和 EOL 非痴呆症照护者之间角色过载和获益的测量不变性。
方法
我们利用了来自 1859 名家庭照护者的角色增益和过载数据，这些照护者参加了全国照护研究的第 7 轮。我们进行了验证性因素分析，以研究所有照护者的因素结构，然后检查了结构在（a）EOL 照护者和非 EOL 照护者之间以及（b）EOL 痴呆症和 EOL 非痴呆症照护者之间的配置、度量和标度不变性。
结果
在整个样本中，两因素过载和增益模型具有良好的拟合度（χ²(19) = 121.37，p <.0001；RMSEA =.053，90%CI = [.044，.062]；CFI =.954；TLI =.932）。比较 EOL 照护者和非 EOL 照护者以及 EOL 痴呆症照护者和 EOL 非痴呆症照护者的不变性检验保持了配置、度量和部分标度不变性。潜在均值比较显示，EOL 照护者的角色过载更高（p =.0002），但角色增益没有差异（p =.45），而非 EOL 照护者则相反。同样，EOL 痴呆症照护者的角色过载更高（p =.05），但角色增益没有差异（p =.42），而非 EOL 非痴呆症照护者则相反。
讨论
结果为深入了解临终痴呆症照护者的角色过载和获益体验提供了理论依据，同时也为衡量这些体验提供了实用工具。
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