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新冠疫情期间长期护理机构中痴呆症亲属的照护:一项前瞻性纵向研究

Caring for a Relative With Dementia in Long-Term Care During the COVID-19 Pandemic: A Prospective Longitudinal Study.

作者信息

Mitchell Lauren L, Horn Brenna, Stabler Henry, Birkeland Robyn W, Peterson Colleen M, Albers Elle A, Gaugler Joseph E

机构信息

Department of Psychology & Neuroscience, Emmanuel College, Boston, Massachusetts, USA.

School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

Innov Aging. 2023 Apr 17;7(4):igad034. doi: 10.1093/geroni/igad034. eCollection 2023.

Abstract

BACKGROUND AND OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic introduced unprecedented threats and disruptions for caregivers of people with dementia living in residential long-term care (LTC) facilities. Qualitative and cross-sectional studies have reported substantial negative effects of the pandemic on dementia caregivers' well-being, but little to no prospective research has examined the impact of COVID-19 on caregiver well-being using pre-pandemic assessments. The present study used longitudinal data from an ongoing randomized controlled trial of a psychosocial intervention to support family caregivers whose relatives had entered LTC.

RESEARCH DESIGN AND METHODS

Data collection began in 2016 and continued through 2021. Caregivers ( = 132) completed up to 7 assessments measuring their depressive symptoms, self-efficacy, and burden.

RESULTS

Latent growth curve models testing preregistered hypotheses revealed no significant effects of the pandemic on caregiver outcomes on average, though caregivers varied in terms of individual intercepts and slopes. Furthermore, factors such as caregiver-care recipient relationship closeness, care recipient's COVID-19 infection status, and caregivers' ratings of LTC facilities' COVID-19 policies did not significantly moderate trajectories of well-being.

DISCUSSION AND IMPLICATIONS

Findings highlight the heterogeneity of caregivers' experiences during the pandemic, and suggest caution when interpreting cross-sectional findings on the impacts of the COVID-19 pandemic on caregiver well-being and distress.

摘要

背景与目的

2019年冠状病毒病(COVID-19)大流行给居住在长期护理(LTC)机构中的痴呆症患者的照护者带来了前所未有的威胁和干扰。定性和横断面研究报告了大流行对痴呆症照护者幸福感的重大负面影响,但很少有前瞻性研究使用大流行前的评估来考察COVID-19对照护者幸福感的影响。本研究使用了一项正在进行的社会心理干预随机对照试验的纵向数据,该试验旨在支持亲属已入住长期护理机构的家庭照护者。

研究设计与方法

数据收集始于2016年,持续至2021年。照护者(n = 132)完成了多达7次评估,测量他们的抑郁症状、自我效能感和负担。

结果

检验预先注册假设的潜在增长曲线模型显示,大流行对照护者的平均结果没有显著影响,尽管照护者在个体截距和斜率方面存在差异。此外,诸如照护者与受照护者关系亲密度、受照护者的COVID-19感染状况以及照护者对长期护理机构COVID-19政策的评分等因素,并未显著调节幸福感轨迹。

讨论与启示

研究结果突出了大流行期间照护者经历的异质性,并表明在解释关于COVID-19大流行对照护者幸福感和痛苦影响的横断面研究结果时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e94/10195573/2287bbc22515/igad034_fig1.jpg

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