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积极的照顾方面可以减轻痴呆症家庭照顾者的行为困扰与焦虑和抑郁症状之间的关系。

Positive aspects of caregiving attenuate the relationship between behavioral bother and anxiety and depressive symptoms in dementia family caregivers.

机构信息

Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong.

出版信息

Geriatr Gerontol Int. 2023 May;23(5):366-370. doi: 10.1111/ggi.14581. Epub 2023 Apr 17.

Abstract

AIM

To examine the protective role of positive aspects of caregiving (PAC) in terms of whether it dampens the relationship between behavioral bother and anxiety/depressive symptoms.

METHODS

The baseline data of the Resources for Enhancing Alzheimer's Caregiver Health I trial were used. US dementia family caregivers (N = 1222) responded to standard self-report measures of PAC, behavioral bother, depression, anxiety, challenging behaviors, and functional impairment. The buffering effect of PAC was tested using moderational regression.

RESULTS

Controlling for caregivers' age, sex and behavioral bother, and care-recipients' challenging behaviors and functional impairment, PAC was mildly inversely related to depressive and anxiety symptoms. Moreover, a significant PAC × behavioral bother interaction effect was found such that the relationship between behavioral bother, on the one hand, and depression and anxiety, on the other, became weaker with higher PAC. In particular, when behavioral bother was low, depressive and anxiety symptoms were similar regardless of levels of PAC. But when behavioral bother was high, caregivers who reported higher levels of PAC were less depressed and anxious than those with lower levels, with their standardized mean differences being small to moderate.

CONCLUSIONS

PAC was found to be associated with less mood symptoms partly directly and partly through modifying the effect of behavioral bother on depression and anxiety. Caregivers who were highly troubled by the relative's challenging behaviors, but who found higher levels of PAC at the same time, experienced better emotional well-being. Having PAC may make the burden of caregiving more tolerable, thereby alleviating caregiver distress down the road. Geriatr Gerontol Int 2023; 23: 366-370.

摘要

目的

探讨积极的照护方面(PAC)的保护作用,即其是否能减轻行为困扰与焦虑/抑郁症状之间的关系。

方法

使用强化阿尔茨海默病照护者健康 I 期临床试验的基线数据。美国痴呆症家庭照护者(N=1222)对 PAC、行为困扰、抑郁、焦虑、挑战性行为和功能障碍的标准自我报告措施做出了回应。使用调节回归来检验 PAC 的缓冲作用。

结果

在控制了照护者的年龄、性别和行为困扰,以及被照护者的挑战性行为和功能障碍后,PAC 与抑郁和焦虑症状呈轻度负相关。此外,还发现了 PAC与行为困扰之间存在显著的交互作用效应,即行为困扰与抑郁和焦虑之间的关系随着 PAC 的增加而减弱。具体而言,当行为困扰较低时,无论 PAC 水平如何,抑郁和焦虑症状都相似。但是当行为困扰较高时,报告 PAC 水平较高的照护者比报告 PAC 水平较低的照护者抑郁和焦虑程度较低,其标准化均数差异较小到中等。

结论

PAC 与情绪症状较少有关,部分是直接相关,部分是通过改变行为困扰对抑郁和焦虑的影响。那些被相对人的挑战性行为困扰很大,但同时又发现 PAC 水平较高的照护者,情绪健康状况较好。拥有 PAC 可能会使照护负担更具可承受性,从而减轻照护者日后的痛苦。老年病学与老年医学国际 2023; 23: 366-370。

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