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痴呆症患者家庭照顾者的正念与照顾体验

Mindfulness and Care Experience in Family Caregivers of Persons Living with Dementia.

作者信息

Tolea Magdalena I, Camacho Simone, Cohen Iris R, Galvin James E

机构信息

Comprehensive Center for Brain Health, Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

J Alzheimers Dis Rep. 2023 Feb 14;7(1):151-164. doi: 10.3233/ADR-220069. eCollection 2023.

Abstract

BACKGROUND

Greater mindfulness, the practice of awareness and living in the moment without judgement, has been linked to positive caregiving outcomes in dementia caregivers and its impact attributed to greater decentering and emotion regulation abilities. Whether the impact of these mindfulness-based processes varies across caregiver subgroups is unclear.

OBJECTIVE

Analyze cross-sectional associations between mindfulness and caregiver psychosocial outcomes, considering different caregiver and patient characteristics.

METHODS

A total of 128 family caregivers of persons living with Alzheimer's disease and related disorders were assessed on several mindfulness measures (i.e., global; decentering, positive emotion regulation, negative emotion regulation) and provided self-reported appraisals of caregiving experience; care preparedness; confidence, burden, and depression/anxiety. Bivariate relationships between mindfulness and caregiver outcomes were assessed with Pearson's correlations and stratified by caregiver (women versus men; spouse versus adult child) and patient (mild cognitive impairment (MCI) versus Dementia; AD versus dementia with Lewy bodies; low versus high symptom severity) characteristics.

RESULTS

Greater mindfulness was associated with positive outcomes and inversely associated with negative outcomes. Stratification identified specific patterns of associations across caregiver groups. Significant correlations were found between all mindfulness measures and caregiving outcomes in male and MCI caregivers while the individual mindfulness component of positive emotion regulation was significantly correlated to outcomes in most caregiver groups.

CONCLUSION

Our findings support a link between caregiver mindfulness and improved caregiving outcomes and suggest directions of inquiry into whether the effectiveness of dementia caregiver-support interventions may be improved by targeting specific mindfulness processes or offering a more inclusive all-scope approach depending on individual caregiver or patient characteristics.

摘要

背景

更高水平的正念,即不加评判地觉察当下并活在当下的实践,已被证明与痴呆症照护者的积极照护结果相关,其影响归因于更强的去中心化和情绪调节能力。这些基于正念的过程的影响在不同照护者亚组中是否存在差异尚不清楚。

目的

考虑不同的照护者和患者特征,分析正念与照护者心理社会结果之间的横断面关联。

方法

对128名患有阿尔茨海默病及相关疾病患者的家庭照护者进行了多项正念测量(即总体正念、去中心化、积极情绪调节、消极情绪调节),并让他们自我报告对照护经历、照护准备、信心、负担以及抑郁/焦虑的评估。通过Pearson相关性分析评估正念与照护者结果之间的双变量关系,并按照护者(女性与男性;配偶与成年子女)和患者(轻度认知障碍[MCI]与痴呆症;阿尔茨海默病[AD]与路易体痴呆;低症状严重程度与高症状严重程度)特征进行分层。

结果

更高水平的正念与积极结果相关,与消极结果呈负相关。分层分析确定了不同照护者群体之间的特定关联模式。在男性和MCI照护者中,所有正念测量与照护结果之间均存在显著相关性,而积极情绪调节的个体正念成分在大多数照护者群体中与结果显著相关。

结论

我们的研究结果支持照护者正念与改善照护结果之间的联系,并建议开展研究,探讨是否可以通过针对特定的正念过程或根据个体照护者或患者特征提供更具包容性的全面方法来提高痴呆症照护者支持干预措施的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb9c/9986707/ece372f73fae/adr-7-adr220069-g001.jpg

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