Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, 21527, Alexandria, Egypt.
Department of Psychiatry, College of Medicine, Qassim University, Buraidah, Saudi Arabia.
Sci Rep. 2024 Jun 6;14(1):13075. doi: 10.1038/s41598-024-60127-1.
The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.
全球人口老龄化趋势导致与年龄相关疾病的发病率上升。痴呆是一种常见的多因素与年龄相关的神经退行性疾病，其表现为认知功能进行性下降，以及日常生活活动能力下降。由于政策不鼓励机构护理，家庭成员成为主要照顾者，并且由于生活常规和人际关系的护理相关变化，他们更容易出现身心健康问题。通过有效的简短措施在早期发现具有临床意义的痛苦，可能会促进照顾者的幸福感和痴呆症护理的连续性/质量。本研究旨在通过三种方法确定 571 名欧洲照顾者（平均年龄 53±12 岁，意大利人 74.4%，瑞士人 25.6%）便利样本中 8 项抑郁焦虑压力量表（DASS-8）的最佳截断分数。基于 DASS-8 得分 19，使用 K-均值聚类将样本分为高压力和低压力组。使用 Zarit 负担量表（ZBI）和加利福尼亚大学洛杉矶分校三项孤独量表（UCLALS3）的 48 和 7 个截断值进行接收者操作特征曲线（ROC）分析，发现了两个 DASS-8 截断值（12.5 和 14.5，曲线下面积（AUC）分别为 0.85 和 0.92，p 值均<.001，95%CI 0.82-0.88 和 0.89-0.94，敏感性分别为 0.81 和 0.78，特异性分别为 0.76 和 0.89，约登指数分别为 0.57 和 0.67）。决策模型产生了两个 DASS-8 截断值（9.5 和 14.5），分别用于预测低和高的护理负担和孤独感。根据所有 DASS-8 截断值的中位数（14.5），精神困扰的患病率为 50.8%。在路径分析中，压力与关键的精神问题相关，如倦怠和孤独，在路径分析中，DASS-8 分数由 ZBI、UCLALS3、护理依赖和接受护理帮助预测，尤其是在年龄较大、女性和配偶照顾者中。应进一步进行诊断性检查以确认 DASS-8 评分超过 14.5 的照顾者的精神病理。在其他国家/人群中对 DASS-8 的研究可能会证实这一切断值的有效性。
