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共享活动作为预防痴呆症行为和心理症状及照顾者压力的保护因素。

Shared Activities as a Protective Factor Against Behavioral and Psychological Symptoms of Dementia and Caregiver Stress.

作者信息

Petrovsky Darina V, Yildiz Mustafa, Yefimova Maria, Sefcik Justine S, Baker Zachary G, Ma Kris Pui Kwan, Rahemi Zahra, Bacsu Juanita-Dawne R, Smith Matthew Lee, Pickering Carolyn E Z

机构信息

Division of Women, Children, & Families, Duke University School of Nursing, Durham, North Carolina, USA.

Department of Research, Jane and Robert Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.

出版信息

Innov Aging. 2024 Mar 11;8(5):igae034. doi: 10.1093/geroni/igae034. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVES

Most persons with dementia experience behavioral and psychological symptoms (BPSD). While there is evidence that structured activity programs can be beneficial for persons with dementia and their caregivers, it is not well understood how joint engagement in shared activities affects BPSD and caregiver stress. The purpose of this study was to examine the moderating effect of doing a shared activity on the BPSD and caregiver stress.

RESEARCH DESIGN AND METHODS

This study used an intensive longitudinal observational design in which caregivers completed baseline and once-a-day diary surveys for 21 days. Caregivers were asked whether they did a pleasant noncare activity with their relative, the presence of 8 BPSD, and their stress level. A moderation model in a structural equation model examined the relationship between these variables.

RESULTS

Our sample consisted of 453 caregivers (87.4% female, 51.4% non-Hispanic White, mean age 53 years [standard deviation {}: 14]) and person living with dementia whose mean age was 79 years (: 9). On days when the caregivers engaged in a shared activity together with person living with dementia, there was a significant decrease in the BPSD (estimate -0.038, standard error [] = 0.016, 95% confidence interval [CI]: -0.069, -0.007, value = 0.018). The effects of engaging in a shared activity decreased the impact of caregiver stress by 0.052 (estimate -0.052, = 0.018, 95% CI: -0.087, -0.017, value = 0.004). At the between-person level, no differences were found in BPSD across caregivers who engaged or did not engage in shared activities.

DISCUSSION AND IMPLICATIONS

The results of our study indicate that doing a shared activity is associated with reduced BPSD among persons with dementia and may buffer the impact of caregiver stress on BPSD. Shared activities should be considered a key intervention component for dementia caregivers.

摘要

背景与目的

大多数痴呆症患者会出现行为和心理症状(BPSD)。虽然有证据表明结构化活动项目对痴呆症患者及其照料者有益,但对于共同参与共享活动如何影响BPSD和照料者压力,人们还了解得不够充分。本研究的目的是检验进行共享活动对BPSD和照料者压力的调节作用。

研究设计与方法

本研究采用密集纵向观察设计,照料者需完成基线调查以及为期21天的每日日记调查。研究人员询问照料者是否与他们的亲属进行了愉快的非照料活动、8种BPSD的存在情况以及他们的压力水平。结构方程模型中的调节模型检验了这些变量之间的关系。

结果

我们的样本包括453名照料者(87.4%为女性,51.4%为非西班牙裔白人,平均年龄53岁[标准差{}:14])以及平均年龄为79岁(: 9)的痴呆症患者。在照料者与痴呆症患者一起参与共享活动的日子里,BPSD显著减少(估计值-0.038,标准误差[] = 0.016,95%置信区间[CI]:-0.069,-0.007, 值 = 0.018)。参与共享活动的效果使照料者压力的影响降低了0.052(估计值-0.052, = 0.018,95% CI:-0.087,-0.017, 值 = 0.004)。在个体间水平上,参与或未参与共享活动的照料者在BPSD方面未发现差异。

讨论与启示

我们的研究结果表明,进行共享活动与痴呆症患者BPSD的减少相关,并且可能缓冲照料者压力对BPSD的影响。共享活动应被视为痴呆症照料者的关键干预组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ace/11037273/2728235aa4bf/igae034_fig1.jpg

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