Chou Pei-Chien, Lee Yu, Chang Yung-Yee, Hung Chi-Fa, Chen Ying-Fa, Lin Tsu-Kung, Shih Fu-Yuan, Chen Wu-Fu, Lin Pao-Yen, Chong Mian-Yoon, Wang Liang-Jen
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Healthcare (Basel). 2024 Apr 23;12(9):878. doi: 10.3390/healthcare12090878.
Parkinson's disease (PD) is a debilitating neurodegenerative disease with a relentlessly progressive course of illness. This study aimed to assess the dyadic dynamics of benefit finding (BF), demoralization, and stigma on the depression severity of PD patients and their caregivers. This study used a cross-sectional design with purposive sampling. In total, 120 PD patients and 120 caregivers were recruited from the neurological ward or neurological outpatient clinic of a medical center in Taiwan from October 2021 to September 2022. PD patients and their caregivers were enrolled and assessed using the Mini International Neuropsychiatric Interview, the Benefit Finding scale, Demoralization Scale, Stigma Subscale of the Explanatory Model Interview Catalogue, and Taiwanese Depression Questionnaire. Among the 120 patients and 120 caregivers that successfully completed the study, 41.7% (N = 50) and 60% (N = 72) were female, respectively. The most common psychiatric diagnoses of both the PD patients (17.5%) and their caregivers (13.3%) were depressive disorders. Using structural equation modeling, we found that the stigma, BF, and demoralization of PD patients might contribute to their depression severity. Demoralization and stigma of PD patients' caregivers might also contribute to the depression severity of PD patients. Caregivers' BF and demoralization were significantly linked with their depression severity. PD patients' BF degree and their caregivers' BF degree had significant interactive effects. Both patients' and their caregivers' stigma levels had significant interactive effects. Clinicians should be aware of and manage these contributing factors between PD patients and their caregivers in order to prevent them from exacerbating each other's depression.
帕金森病（PD）是一种使人衰弱的神经退行性疾病，病情呈持续进展。本研究旨在评估益处发现（BF）、士气低落和耻辱感对PD患者及其照料者抑郁严重程度的二元动态关系。本研究采用目的抽样的横断面设计。2021年10月至2022年9月，从台湾某医疗中心的神经科病房或神经科门诊招募了120名PD患者和120名照料者。使用迷你国际神经精神访谈、益处发现量表、士气低落量表、解释模型访谈目录的耻辱感子量表和台湾抑郁问卷对PD患者及其照料者进行登记和评估。在成功完成研究的120名患者和120名照料者中，女性分别占41.7%（N = 50）和60%（N = 72）。PD患者（17.5%）及其照料者（13.3%）最常见的精神科诊断均为抑郁障碍。通过结构方程模型，我们发现PD患者的耻辱感、BF和士气低落可能导致其抑郁严重程度增加。PD患者照料者的士气低落和耻辱感也可能导致PD患者的抑郁严重程度增加。照料者的BF和士气低落与他们的抑郁严重程度显著相关。PD患者的BF程度和其照料者的BF程度有显著的交互作用。患者及其照料者的耻辱感水平均有显著的交互作用。临床医生应意识到并管理PD患者及其照料者之间的这些影响因素，以防止它们使彼此的抑郁状况恶化。
