“曾经沧海难为水”：痴呆症父母的前照护者对未来照护准备情况的扎根理论。
"Been there, done that:" A grounded theory of future caregiver preparedness in former caregivers of parents living with dementia.
机构信息
Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
出版信息
J Am Geriatr Soc. 2023 May;71(5):1495-1504. doi: 10.1111/jgs.18209. Epub 2022 Dec 26.
BACKGROUND
Family caregivers offer essential support to persons living with dementia (PLWD). Providing care for more than one family member or close other across adulthood is becoming increasingly common, yet little is known about the ways that caregiving experiences shape caregiver preparedness. The current study presents a grounded theory of future caregiver preparedness in former caregivers of PLWD.
METHOD
A coding team (five coders and two auditors) used Consensual Qualitative Research and grounded theory techniques to analyze transcripts from 32 semi-structured interviews with midlife former caregivers of parents who died following advanced Alzheimer's disease and related dementias.
RESULTS
Qualitative analysis revealed two dimensions of future caregiver preparedness: caregiving confidence and caregiving insights. Narratives from caregiving experiences informed participants' descriptions of their future caregiver preparedness. Though some former caregivers described a positive (i.e., boosted or sustained) sense of caregiving confidence following care for their parents, others described a diminished (i.e., restricted or impeded) sense of confidence. Regardless of their confidence, all caregivers described specific caregiving insights related to one or more categories (i.e., caregiving self-conduct, care systems and resources, and relating with a care partner).
CONCLUSIONS
Preparedness for future caregiving following recent care for a PLWD varies: For some, past experiences appear to offer cumulative advantages in anticipating future care roles, whereas for others, past experiences may contribute to apprehension towards, or rejection of, future care roles. Entering new caregiving roles with diminished confidence may have negative consequences for caregivers' and care partners' wellbeing. Multidimensional assessment of future caregiver preparedness in former caregivers of PLWD may support development of resources for former caregivers entering new caregiving roles.
背景
家庭照顾者为患有痴呆症（PLWD）的人提供重要支持。在成年后为不止一位家庭成员或亲密他人提供护理的情况越来越普遍，但人们对照顾经历如何影响照顾者的准备情况知之甚少。本研究提出了一个针对 PLWD 前照顾者未来照顾者准备情况的扎根理论。
方法
一个编码团队（五名编码员和两名审核员）使用共识定性研究和扎根理论技术，对 32 名中度前照顾者的半结构化访谈记录进行了分析，这些照顾者的父母在晚期阿尔茨海默病和相关痴呆症后去世。
结果
定性分析揭示了未来照顾者准备情况的两个维度：照顾信心和照顾洞察力。来自照顾经历的叙述为参与者描述他们未来的照顾者准备情况提供了信息。虽然一些前照顾者描述了在照顾父母后的积极（即增强或维持）照顾信心，但其他人描述了信心减弱（即限制或阻碍）。无论他们的信心如何，所有照顾者都描述了与一个或多个类别（即照顾自我行为、照顾系统和资源以及与照顾伙伴的关系）相关的特定照顾洞察力。
结论
在照顾 PLWD 后的未来照顾准备情况各不相同：对于一些人来说，过去的经历似乎为他们预测未来的照顾角色提供了累积优势，而对于另一些人来说，过去的经历可能会导致他们对未来的照顾角色感到担忧或拒绝。带着信心减弱进入新的照顾角色可能会对照顾者和照顾伙伴的幸福感产生负面影响。对 PLWD 前照顾者未来照顾者准备情况进行多维评估，可能有助于为进入新照顾角色的前照顾者提供资源。
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