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“我知道我的角色将会改变”:一项关于淀粉样蛋白-β PET 扫描结果与照料者负担之间关系的混合方法研究。

"I know that my role is going to change": a mixed-methods study of the relationship between amyloid-β PET scan results and caregiver burden.

机构信息

Center for Gerontology and Healthcare Research, Brown University School of Public Health, Center for Gerontology and Healthcare Research, Providence, RI, USA.

Department of Health Services, Brown University School of Public Health, Policy & Practice, Providence, RI, USA.

出版信息

Aging Clin Exp Res. 2023 Feb;35(2):387-397. doi: 10.1007/s40520-022-02314-6. Epub 2022 Dec 9.

Abstract

BACKGROUND

Caregiver burden consists of disease specific and perceived stressors, respectively referred to as objective and subjective indicators of burden, and is associated with negative outcomes. Previous research has found that care partners to persons living with cognitive impairment and elevated levels of amyloid-β, as measured by a positron emission tomography (PET) scan, may experience caregiver burden.

AIMS

To elucidate the relationship between amyloid scan results and subjective and objective indicators of burden.

METHODS

A parallel mixed-methods design using survey data from 1338 care partners to persons with mild cognitive impairment (MCI) and dementia who received an amyloid scan from the CARE-IDEAS study; and semi-structured interviews with a subsample of 62 care partners. Logistic regression models were used to investigate objective factors associated with caregiver burden. A thematic analysis of semi-structured interviews was used to investigate subjective indicators by exploring care partners' perceptions of their role following an amyloid scan.

RESULTS

Elevated amyloid was not associated with burden. However, the scan result influenced participants perceptions of their caregiving role and coping strategies. Care partners to persons with elevated amyloid expected increasing responsibility, whereas partners to persons without elevated amyloid and mild cognitive impairment did not anticipate changes to their role. Care partners to persons with elevated amyloid reported using knowledge gained from the scan to develop coping strategies. All care partners described needing practical and emotional support.

CONCLUSIONS

Amyloid scans can influence subjective indicators of burden and present the opportunity to identify and address care partners' support needs.

摘要

背景

照顾者负担包括疾病特异性和感知压力源,分别称为负担的客观和主观指标,与负面结果相关。先前的研究发现,照顾者对认知障碍和淀粉样蛋白-β水平升高的人(通过正电子发射断层扫描 [PET] 扫描测量)可能会经历照顾者负担。

目的

阐明淀粉样蛋白扫描结果与负担的主观和客观指标之间的关系。

方法

采用 CARE-IDEAS 研究中对 1338 名轻度认知障碍(MCI)和痴呆症患者的照顾者进行的问卷调查数据和半结构化访谈的平行混合方法设计;对 62 名照顾者进行了半结构化访谈。使用逻辑回归模型调查与照顾者负担相关的客观因素。通过探索照顾者在淀粉样蛋白扫描后的角色认知,对半结构化访谈进行主题分析,以调查主观指标。

结果

淀粉样蛋白升高与负担无关。然而,扫描结果影响了参与者对其照顾角色和应对策略的看法。淀粉样蛋白升高的人的照顾者预计会增加责任,而淀粉样蛋白升高的人和没有淀粉样蛋白升高的轻度认知障碍患者的照顾者则不期望他们的角色发生变化。淀粉样蛋白升高的人的照顾者报告说,他们使用从扫描中获得的知识来制定应对策略。所有的照顾者都表示需要实际的和情感上的支持。

结论

淀粉样蛋白扫描可以影响负担的主观指标,并提供识别和满足照顾者支持需求的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cb3/9735001/737f4e265686/40520_2022_2314_Fig1_HTML.jpg

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