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考虑管理行为,以确定痴呆症患者的弱势照顾者。

Considering management behaviours to identify vulnerable caregivers of persons with dementia.

机构信息

Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France.

Fondation Santé des étudiants de France, Clinique de Villeneuve d'Ascq, Villeneuve d'Ascq, France.

出版信息

Psychogeriatrics. 2023 Jul;23(4):650-656. doi: 10.1111/psyg.12973. Epub 2023 May 5.

Abstract

BACKGROUND

Persons with dementia gradually disengage from daily activities, and therefore require increasing daily support. Caregivers face a dilemma as to whether they should encourage the persons with dementia in terms of initiative and autonomy, or supervise and take charge of tasks, which may cause distress for both parties. This study seeks to better understand how caregivers manage the disengagement of the persons with dementia and the repercussions on their caregiving experience.

METHODS

A total of 217 caregivers participated. Their management behaviours and the characteristics of their caregiving experiences were assessed with questionnaires. A cluster analysis was first performed to identify possible profiles of management behaviours and comparison, which were then compared to identify the caregiving experience associated with each profile.

RESULTS

The first cluster (25.8% of the sample) corresponds to caregivers with high negative control behaviour scores and high positive stimulation behaviour scores; the second cluster (43.8% of the sample) corresponds to caregivers with low positive stimulation behaviour scores and high negative control behaviour scores; and the third cluster (30.4% of the sample) corresponds to caregivers with low negative control behaviour scores and high positive stimulation behaviour scores. Caregivers in Clusters 2 and 3 differ in terms of anxiety, depression, burden, gratification, health and financial problems. Cluster 1 is an intermediate profile with similar characteristics to Cluster 3.

CONCLUSIONS

Our results support the idea of considering management behaviours to identify vulnerable caregivers and highlight the deleterious role of negative control behaviours, especially when they are not offset by positive protective stimulation behaviours.

摘要

背景

痴呆症患者逐渐脱离日常活动,因此需要更多的日常支持。照顾者面临着一个两难的困境,即他们应该鼓励痴呆症患者主动和自主,还是监督和负责任务,这可能会给双方都带来困扰。本研究旨在更好地了解照顾者如何管理痴呆症患者的脱离以及对他们的照顾体验的影响。

方法

共有 217 名照顾者参与。他们的管理行为和照顾体验的特征通过问卷进行评估。首先进行聚类分析,以确定可能的管理行为模式和比较,然后进行比较,以确定与每个模式相关的照顾体验。

结果

第一组(样本的 25.8%)对应于具有高负面控制行为得分和高积极刺激行为得分的照顾者;第二组(样本的 43.8%)对应于具有低积极刺激行为得分和高负面控制行为得分的照顾者;第三组(样本的 30.4%)对应于具有低负面控制行为得分和高积极刺激行为得分的照顾者。第二组和第三组的照顾者在焦虑、抑郁、负担、满足感、健康和经济问题方面存在差异。第一组是一个中间模式,与第三组具有相似的特征。

结论

我们的结果支持考虑管理行为来识别脆弱的照顾者的观点,并强调了负面控制行为的有害作用,特别是当它们没有被积极的保护刺激行为所抵消时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d652/11577979/94f6067acf55/PSYG-23-650-g001.jpg

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