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验证 interRAI 中文自评照顾者需求评估(SCaN)和预测老年人群体的非正式中国照顾者的照护困扰。

Validating interRAI Chinese self-reported carer needs (SCaN) assessment and predicting caregiving distress among informal Chinese caregivers of older adults.

机构信息

Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.

Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China.

出版信息

BMC Geriatr. 2024 May 8;24(1):409. doi: 10.1186/s12877-024-05014-0.

Abstract

BACKGROUND

This study aims to (1) determine the reliability and validity of the interRAI Chinese Self-reported Carer Needs (SCaN) assessment among informal Chinese caregivers of older adults, (2) identify predictors of caregiving distress in Asian regions with long-standing Confucian values of filial piety and family responsibility.

METHODS

This cross-sectional study recruited 531 informal Chinese caregivers of older adults in Hong Kong, Shanghai, Taiwan, and Singapore. The scale reliability was examined using Cronbach's alphas (α) and McDonald's omega coefficient (ω). The concurrent validity and discriminant validity were assessed using Spearman rank correlations (rho). To examine the predictors of caregiving distress among informal caregivers of older adults, we employed hierarchical linear regression analyses informed by the Model of Carer Stress and Burden and categorized the predictors into six domains.

RESULTS

Results revealed good internal consistency reliability (α = 0.83-0.96) and concurrent validity (rho = 0.45-0.74) of the interRAI Chinese SCaN assessment. Hierarchical linear regression analysis revealed that entering the background factors, primary stressors, secondary stressors, appraisal, and exacerbating factors all significantly enhanced the model's predictability, indicating that the source of caregiving distress is multidimensional. In the full model, caregivers with longer informal care time, lack of support from family and friends, have unmet needs, experience role overload, have sleep problems, and low IADL functioning are at a higher risk of caregiving distress.

CONCLUSIONS

The interRAI Chinese SCaN Assessment was found to be a reliable and valid tool among the Chinese informal caregivers of older adults. It would be useful for determining family caregivers' strengths, needs, and challenges, and tailoring interventions that address the potentially modifiable factors associated with caregiving distress and maximize support. Healthcare providers working in home and community settings should be aware of the early identification of caregiving distress and routine assessment of their needs and empower them to continue taking care of their needs and providing adequate care to the care recipient.

摘要

背景

本研究旨在:(1) 确定 interRAI 中文自评照顾者需求评估工具(SCaN)在有长期儒家孝道和家庭责任观念的亚洲地区的非正式老年照顾者中的信度和效度;(2) 确定影响亚洲地区照顾者压力的因素。

方法

本横断面研究在香港、上海、台湾和新加坡招募了 531 名非正式老年照顾者。使用 Cronbach's alpha(α)和 McDonald's omega 系数(ω)评估量表的信度,使用 Spearman 等级相关系数(rho)评估同时效度和区分效度。为了考察老年照顾者的照顾压力的预测因素,我们采用了基于照顾者压力和负担模型的分层线性回归分析,并将预测因素分为六个领域。

结果

研究结果显示,interRAI 中文 SCaN 评估具有良好的内部一致性信度(α=0.83-0.96)和同时效度(rho=0.45-0.74)。分层线性回归分析显示,进入背景因素、主要压力源、次要压力源、评估和恶化因素后,模型的预测能力显著提高,这表明照顾压力的来源是多维度的。在全模型中,照顾时间较长、缺乏家庭和朋友支持、需求未得到满足、角色过载、睡眠问题和 IADL 功能较低的照顾者,其照顾压力较高。

结论

interRAI 中文 SCaN 评估在老年照顾者的中国非正式照顾者中是可靠和有效的。它有助于确定家庭照顾者的优势、需求和挑战,并针对与照顾压力相关的潜在可改变因素进行干预,最大限度地支持照顾者。在家庭和社区环境中工作的医疗保健提供者应注意早期识别照顾压力,并定期评估他们的需求,赋予他们权力,以继续照顾自己的需求并为照顾对象提供足够的照顾。

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