老年痴呆症患者非正式照护者的社会支持、积极的照护体验和照护者负担。

Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia.

机构信息

Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Kosice, Slovakia.

Slovak Public Health Association - SAVEZ, Kosice, Slovakia.

出版信息

Front Public Health. 2023 Jan 25;11:1104250. doi: 10.3389/fpubh.2023.1104250. eCollection 2023.

DOI:10.3389/fpubh.2023.1104250

PMID:36761127

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9905841/

Abstract

INTRODUCTION

Dementia is currently one of the major causes of disability and dependency among older adults worldwide. Cognitive dysfunction, neuropsychiatric symptoms, somatic complaints, and functional impairment fundamentally affect not only a person living with dementia (PLwD), but also his/her informal caregiver(s), often resulting in a high caregiver burden. A number of variables, including the caregiver's sociodemographic characteristics, the clinical characteristics of PLwD, social support, and the caregiver's personal resources determine the caregiver's burden.

OBJECTIVES

The aim of this study was to investigate the associations of caregiver burden in informal caregivers of PLwD with perceived social support, positive caregiving experience, and applying therapeutic communication methods.

METHODS

The data were collected from September 2021 to February 2022 among 115 "PLwD-informal caregiver" dyads in the community settings in Slovakia. Measures included the Zarit Burden Interview (ZBI-12), the Oslo Social Support Scale (OSSS-3), the Positive Aspects of Caregiving Scale (PACS), and two questions on applying therapeutic communication methods-reminiscence and validation according to Naomi Feil. The Short IQCODE was used for assessing cognitive decline in PLwD. Pearson's and Spearman's correlations, -tests, Chi-square, ANOVA, and linear multiple regression analyses were used to analyze the data (IBM SPSS 27).

RESULTS

The mean age of informal caregivers was 54 ± 12.4 years (81.7% of women) and the mean caregiving duration was 4.8 ± 4.8 years. The mean age of PLwD was 80.5 ± 8.3 years (73.0% of women) and their Short IQCODE mean score was 4.1 ± 1.0. Lower caregiving burden was significantly associated with higher perceived social support (β = 0.33, < 0.01), with higher positive caregiving experience (β = 0.33, < 0.01), and higher caregiving intensity (β = 0.24, < 0.05) among informal caregivers of PLwD. The associations between caregiver burden and applying two therapeutic communication methods were not significant.

CONCLUSIONS

Implementing psycho-social and educational public health interventions focused on strengthening social support and maintaining positive perceptions of caregiving can help reduce the increased risk of caregiver burden in informal caregivers of older adults with dementia.

摘要

简介

痴呆症是目前全球导致老年人残疾和依赖的主要原因之一。认知功能障碍、神经精神症状、躯体抱怨和功能障碍不仅对患有痴呆症的人（PLwD），而且对其非正式照顾者产生根本性的影响，经常导致照顾者负担过重。许多变量，包括照顾者的社会人口统计学特征、PLwD 的临床特征、社会支持以及照顾者的个人资源，决定了照顾者的负担。

目的

本研究旨在调查照顾者负担与非正式照顾者对社会支持的感知、积极的照顾体验以及应用治疗性沟通方法之间的关系。

方法

数据于 2021 年 9 月至 2022 年 2 月期间在斯洛伐克社区环境中从 115 名“PLwD-非正式照顾者”对中收集。测量包括 Zarit 负担量表（ZBI-12）、奥斯陆社会支持量表（OSSS-3）、积极照顾量表（PACS）以及根据 Naomi Feil 应用治疗性沟通方法的两个问题-回忆和验证。PLwD 的认知能力下降采用简短的 IQCODE 进行评估。采用 Pearson 和 Spearman 相关性、t 检验、卡方检验、方差分析和线性多元回归分析（IBM SPSS 27）对数据进行分析。

结果

非正式照顾者的平均年龄为 54 ± 12.4 岁（81.7%为女性），平均照顾时间为 4.8 ± 4.8 年。PLwD 的平均年龄为 80.5 ± 8.3 岁（73.0%为女性），其简短 IQCODE 平均得分为 4.1 ± 1.0。较低的照顾负担与较高的感知社会支持（β=0.33，<0.01）、较高的积极照顾体验（β=0.33，<0.01）和较高的照顾强度（β=0.24，<0.05）显著相关。照顾者负担与应用两种治疗性沟通方法之间的关联没有统计学意义。