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痴呆症患者配偶照顾者的健康状况及其与压力、照顾经历和社交网络的关系:IDEAL项目的纵向研究结果

Health conditions in spousal caregivers of people with dementia and their relationships with stress, caregiving experiences, and social networks: longitudinal findings from the IDEAL programme.

作者信息

Sabatini Serena, Martyr Anthony, Hunt Anna, Gamble Laura D, Matthews Fiona E, Thom Jeanette M, Jones Roy W, Allan Louise, Knapp Martin, Quinn Catherine, Victor Christina, Pentecost Claire, Rusted Jennifer M, Morris Robin G, Clare Linda

机构信息

Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.

University of Exeter Medical School, University of Exeter, Exeter, UK.

出版信息

BMC Geriatr. 2024 Feb 19;24(1):171. doi: 10.1186/s12877-024-04707-w.

Abstract

Longitudinal evidence documenting health conditions in spousal caregivers of people with dementia and whether these influence caregivers' outcomes is scarce. This study explores type and number of health conditions over two years in caregivers of people with dementia and subgroups based on age, sex, education, hours of care, informant-rated functional ability, neuropsychiatric symptoms, cognition of the person with dementia, and length of diagnosis in the person with dementia. It also explores whether over time the number of health conditions is associated with caregivers' stress, positive experiences of caregiving, and social networks METHODS: Longitudinal data from the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort were used. Participants comprised spousal caregivers (n = 977) of people with dementia. Self-reported health conditions using the Charlson Comorbidity Index, stress, positive experiences of caregiving, and social network were assessed over two years. Mixed effect models were used RESULTS: On average participants had 1.5 health conditions at baseline; increasing to 2.1 conditions over two years. More health conditions were reported by caregivers who were older, had no formal education, provided 10 + hours of care per day, and/or cared for a person with more neuropsychiatric symptoms at baseline. More baseline health conditions were associated with greater stress at baseline but not with stress over time. Over two years, when caregivers' health conditions increased, their stress increased whereas their social network diminished DISCUSSION: Findings highlight that most caregivers have their own health problems which require management to avoid increased stress and shrinking of social networks.

摘要

记录痴呆症患者配偶照顾者的健康状况以及这些状况是否会影响照顾者结局的纵向证据很少。本研究探讨了痴呆症患者照顾者在两年内的健康状况类型和数量,以及基于年龄、性别、教育程度、护理时长、 informant 评定的功能能力、神经精神症状、痴呆症患者的认知情况以及痴呆症患者的诊断时长划分的亚组情况。研究还探讨了随着时间推移,健康状况的数量是否与照顾者的压力、积极的护理体验以及社交网络相关。方法:使用了来自 IDEAL(改善痴呆症体验和促进积极生活)队列的纵向数据。参与者包括痴呆症患者的配偶照顾者(n = 977)。在两年时间里评估了使用 Charlson 合并症指数自我报告的健康状况、压力、积极的护理体验和社交网络。使用了混合效应模型。结果:平均而言,参与者在基线时有 1.5 种健康状况;两年内增加到 2.1 种。年龄较大、未接受过正规教育、每天提供 10 小时及以上护理以及 / 或在基线时照顾神经精神症状较多的患者的照顾者报告的健康状况更多。更多的基线健康状况与基线时更大的压力相关,但与随时间推移的压力无关。在两年时间里,当照顾者的健康状况增加时,他们的压力增加,而社交网络减少。讨论:研究结果突出表明,大多数照顾者有自己的健康问题,需要加以管理以避免压力增加和社交网络缩小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7923/10875834/b9be66f17a16/12877_2024_4707_Fig1_HTML.jpg

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