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乌干达阿尔茨海默病及相关痴呆患者家属的心理困扰。

Psychological distress among family caregivers of persons with Alzheimer's disease and related dementias in Uganda.

机构信息

Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Department of Psychiatry, Makerere University College of Health Sciences, School of public Health, Kampala, Kampala, Uganda.

出版信息

BMC Geriatr. 2024 Jul 15;24(1):602. doi: 10.1186/s12877-024-05190-z.

Abstract

BACKGROUND

Alzheimer's disease and related dementias (ADRD) present growing global health challenges, especially in aging populations, such as Uganda. In Uganda, familial caregiving, predominantly undertaken by female relatives, is the primary form of support provided to patients with ADRD. Cultural stigma around dementia and limited access to support services amplify caregivers' challenges. This study examined psychological distress, depression, and quality of life (QoL) among family caregivers of patients with ADRD in Wakiso District, Uganda.

METHODS

This cross-sectional study involved 90 caregivers from three sub-counties in Wakiso, selected through purposive sampling to capture diverse experiences. Participants included caregivers aged 18 years and older who were knowledgeable and had cared for a person with ADRD for not less than six months, with those providing more than 70% of physical care being prioritised. Data were collected using the Kessler Psychological Distress Scale, the Caregiver Dementia Quality of Life Measurement Scale, and the Center for Epidemiologic Studies Depression Scale, with an 80% response rate achieved through local collaboration. The statistical analyses focused on psychological distress, QoL, and depression.

RESULTS

The study included 82.2% females and 17.8% males, with a median age of 52 years for females and 35 years, respectively. Females were more likely to be single or widowed, whereas males were more likely to be married. The study revealed a high prevalence of psychological distress and depression among caregivers (64.4%) regardless of sex. The analysis indicated that having children was a significant predictor of better QoL (OR 3.04, 95% CI 1.79-5.66, p = 0.034) and a lower risk of depression (OR 0.10, 95% CI 0.01-0.86, p = 0.036). No other sociodemographic factors were significantly associated with health outcomes across the models.

CONCLUSION

Our findings revealed a heavy burden of psychological distress and depression among Ugandan caregivers of patients with ADRD, highlighting the need for structured support systems, including mental health services and gender-responsive interventions in low-resource settings.

摘要

背景

阿尔茨海默病和相关痴呆症(ADRD)在全球范围内构成了日益严峻的健康挑战,尤其是在老龄化人口中,如乌干达。在乌干达,家庭护理主要由女性亲属承担,是为 ADRD 患者提供的主要支持形式。痴呆症的社会污名和支持服务的有限获取加剧了护理人员的挑战。本研究调查了乌干达瓦基索地区 ADRD 患者的家庭护理人员的心理困扰、抑郁和生活质量(QoL)。

方法

这是一项横断面研究,涉及乌干达瓦基索三个分区的 90 名护理人员,通过目的抽样选择,以捕捉不同的经验。参与者包括年龄在 18 岁及以上、对 ADRD 患者有一定了解且护理时间不少于六个月的人员,优先考虑提供超过 70%的身体护理的人员。使用 Kessler 心理困扰量表、护理人员痴呆症生活质量测量量表和流行病学研究中心抑郁量表收集数据,通过当地合作实现了 80%的回应率。统计分析侧重于心理困扰、QoL 和抑郁。

结果

研究包括 82.2%的女性和 17.8%的男性,女性的中位数年龄为 52 岁,男性为 35 岁。女性更有可能是单身或丧偶,而男性更有可能已婚。研究表明,无论性别如何,护理人员的心理困扰和抑郁发生率都很高(64.4%)。分析表明,有子女是 QoL 更好的重要预测因素(OR 3.04,95%CI 1.79-5.66,p=0.034),也是抑郁风险降低的重要预测因素(OR 0.10,95%CI 0.01-0.86,p=0.036)。没有其他社会人口因素在各模型中与健康结果显著相关。

结论

我们的研究结果表明,乌干达 ADRD 患者家庭护理人员的心理困扰和抑郁负担沉重,这突显了在资源有限的环境中建立结构化支持系统的必要性,包括心理健康服务和性别响应干预。

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