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在认知障碍患者中,照护者更好的掌控能力与更低的焦虑水平相关。

Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment.

作者信息

Hwang Yeji, McPhillips Miranda V, Huang Liming, Perez G Adriana, Hodgson Nancy A

机构信息

College of Nursing and Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.

University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

出版信息

BMC Nurs. 2023 Sep 7;22(1):307. doi: 10.1186/s12912-023-01471-x.

Abstract

BACKGROUND

When caregivers have a high level of caregiver mastery, their care recipients with cognitive impairment have less behavioral health problems. However, the relationship between caregiver mastery and anxiety among care recipients over time is unknown. Therefore, this study was conducted to examine that better caregiver mastery is associated with less anxiety in individuals with cognitive impairment over time.

METHODS

A secondary data analysis was conducted using the Healthy Patterns Clinical Trial (NCT03682185) dataset and guided by Factors Associated with Behavioral and Psychological Symptoms of Dementia conceptual framework. This study included 154 dyads of individuals with cognitive impairment and their caregivers. Multiple linear regression analyses were performed on changes in anxiety. Model 1 included variables at the level of neurodegeneration (i.e., cognitive impairment and age). Model 2 added patient factors (i.e., sleep problems and depression) with the Model 1. Finally, Model 3 included caregiver factor (i.e., caregiver mastery) with the Model 2 to examine how changes in caregiver mastery influence changes in anxiety of care recipients.

RESULTS

Model 3 was statistically significant; after controlling for variables at the level of neurodegeneration associated with cognitive impairment and patient factors, improvement of caregiver mastery over time (β =-0.230, p = 0.015) was related to decreased anxiety over time (R = 0.1099).

CONCLUSIONS

Caregivers with high caregiver mastery may have better knowledge on how to care for their loved ones and how to manage their neuropsychiatric symptoms. Therefore, improving the level of caregiver mastery by providing psychoeducational programs and resources that family caregivers need will help reduce the frequency of anxiety in individuals with cognitive impairment.

摘要

背景

当照料者具备较高的照料能力时,其认知障碍的照料对象出现行为健康问题的情况较少。然而,照料能力与照料对象随时间推移产生的焦虑之间的关系尚不清楚。因此,本研究旨在探讨更好的照料能力是否与认知障碍个体随时间推移焦虑减少相关。

方法

使用健康模式临床试验(NCT03682185)数据集进行二次数据分析,并以痴呆症行为和心理症状相关因素概念框架为指导。本研究纳入了154对认知障碍个体及其照料者。对焦虑变化进行多元线性回归分析。模型1纳入了神经退行性变水平的变量(即认知障碍和年龄)。模型2在模型1的基础上增加了患者因素(即睡眠问题和抑郁)。最后,模型3在模型2的基础上纳入了照料者因素(即照料能力),以检验照料能力的变化如何影响照料对象焦虑的变化。

结果

模型3具有统计学意义;在控制了与认知障碍相关的神经退行性变水平变量和患者因素后,照料能力随时间的改善(β = -0.230,p = 0.015)与焦虑随时间的减少相关(R = 0.1099)。

结论

具有较高照料能力的照料者可能在如何照顾亲人以及如何管理其神经精神症状方面有更好的知识。因此,通过提供家庭照料者所需的心理教育项目和资源来提高照料能力水平,将有助于减少认知障碍个体的焦虑频率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8a0/10483800/2efc0f57b65c/12912_2023_1471_Fig1_HTML.jpg

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