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二元应对中的差异:与早期痴呆症夫妇的痛苦和生活质量的关联

Discrepancies in dyadic coping: associations with distress and quality of life in couples facing early stage dementia.

作者信息

Muijres Peter, Weitkamp Katharina, Bodenmann Guy, Jenewein Josef

机构信息

University of Zurich, Department of Psychology, Clinical Psychology for Children/Adolescents and Couples/Families, Zurich, Switzerland.

Private Clinic Hohenegg, Meilen, Switzerland.

出版信息

Front Psychol. 2023 May 24;14:1056428. doi: 10.3389/fpsyg.2023.1056428. eCollection 2023.

DOI:10.3389/fpsyg.2023.1056428
PMID:37292502
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10246685/
Abstract

OBJECTIVES

Due to an aging population, the number of persons living with dementia (PWDs) is increasing worldwide. Romantic partners, as informal caregivers (IC) of PWDs, are often adopting additional tasks. The concept of dyadic coping (DC) addresses how couples cope with stress together. For dyadic coping to be successful, efforts of both partners should be equal. The current study examines how discrepancies in PWDs and ICs perspectives on DC relate to distress and quality of life in each partner within couples facing early stage dementia (ESD).

METHODS

A total of 37 mixed-sex couples including one partner with ESD completed self-report questionnaires. Discrepancies in reciprocity (comparing provided or received levels of DC between partners), equity (each partner balancing own levels received and provided), and congruence (the agreement about levels of DC exchanged between partners) and their covariation with distress and quality of life (QoL) of each partner were measured.

RESULTS

Both partners indicated a discrepancy in reciprocity: PWDs reported receiving more DC than ICs reported receiving, which was associated with higher QoL in PWDs and lower QoL in ICs. Inequities were found in ICs only, who reported receiving less DC, than providing. No relation between inequities and distress or QoL was found. ICs reported more incongruencies than PWDs did, which was associated with higher QoL and less depression in partners.

DISCUSSION

A redivision of tasks and roles in the early stage of dementia is associated with different experiences and views between partners. Whereas ICs take over most household and care tasks within the couple, their effort was considered less helpful by PWDs than by ICs. A high care burden is associated with a compromised quality of ICs' social life and living conditions. The clinical implications of the results are discussed.

摘要

目的

由于人口老龄化,全球痴呆症患者(PWD)的数量正在增加。浪漫伴侣作为PWD的非正式照顾者(IC),常常承担额外的任务。二元应对(DC)概念探讨了夫妻如何共同应对压力。为使二元应对成功,双方的努力应均等。本研究考察了PWD和IC在DC观点上的差异如何与早期痴呆症(ESD)夫妻中各伴侣的痛苦程度和生活质量相关。

方法

共有37对混合性别的夫妻,其中一方患有ESD,他们完成了自我报告问卷。测量了双方在互惠性(比较伴侣之间提供或接受的DC水平)、公平性(每个伴侣平衡自己接受和提供的水平)和一致性(关于伴侣之间交换的DC水平的共识)方面的差异,以及这些差异与各伴侣的痛苦程度和生活质量(QoL)的协变关系。

结果

双方都表示在互惠性上存在差异:PWD报告接受的DC比IC报告接受的更多,这与PWD较高的QoL和IC较低的QoL相关。仅在IC中发现了不公平现象,他们报告接受的DC比提供的少。未发现不公平现象与痛苦程度或QoL之间的关系。IC报告的不一致情况比PWD更多,这与伴侣较高的QoL和较少的抑郁相关。

讨论

痴呆症早期任务和角色的重新划分与伴侣之间不同的经历和观点相关。虽然IC在夫妻中承担了大部分家务和护理任务,但PWD认为他们的努力不如IC自己认为的那么有帮助。高护理负担与IC的社交生活质量和生活条件受损相关。讨论了结果的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba5/10246685/64a68b08ab96/fpsyg-14-1056428-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba5/10246685/64a68b08ab96/fpsyg-14-1056428-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba5/10246685/64a68b08ab96/fpsyg-14-1056428-g001.jpg

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Longitudinal study: understanding the lived experience of couples across the trajectory of dementia.纵向研究:了解痴呆症轨迹中夫妇的生活体验。
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Thematic Analysis of Dyadic Coping in Couples With Young-Onset Dementia.
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Fair enough? Decreased equity of dyadic coping across the transition to parenthood associated with depression of first-time parents.说得通吗?与首次为人父母的抑郁相关的,是向为人父母过渡过程中二元应对能力的公平性下降。
PLoS One. 2020 Feb 19;15(2):e0227342. doi: 10.1371/journal.pone.0227342. eCollection 2020.
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