Department of Human Ecology, University of California, Davis, Davis, California, USA.
Department of Human Development and Family Science, University of Missouri, Columbia, Missouri, USA.
J Gerontol B Psychol Sci Soc Sci. 2024 Sep 1;79(9). doi: 10.1093/geronb/gbae130.
Caring for a spouse with Alzheimer's disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers' ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties' perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the correlates and well-being outcomes of such ambivalence in this unique context.
Participants included 72 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners' demographic characteristics and their spouses' behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms.
Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers' ambivalence. Caregivers' distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses' life satisfaction but there were also indirect effects via ambivalence.
This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.
照顾患有阿尔茨海默病（AD）的配偶会引起相当大的痛苦，但也有积极的时刻。越来越多的研究已经检查了照顾者在照顾关系中的矛盾心理，并将其与抑郁等负面照顾者结果联系起来，但缺乏对双方观点的对偶评估。我们在 AD 患者及其配偶照顾者中检查了矛盾心理，试图确定在这种特殊情况下这种矛盾心理的相关性和幸福感结果。
参与者包括 72 对管理早期 AD 的夫妇。AD 患者和配偶照顾者分别自我报告积极和消极的关系质量（用于间接计算他们的矛盾心理）以及生活满意度。照顾者报告了双方的人口统计学特征以及他们配偶的行为和心理症状的痴呆症（BPSD），重点关注记忆相关的行为和心理症状。
路径分析显示，AD 患者的心理症状数量和频率与他们自己和照顾者的矛盾心理呈正相关。照顾者对记忆相关行为和心理症状的困扰评分与他们的矛盾心理呈正相关。配偶的矛盾心理越大，生活满意度越低。BPSD 直接影响配偶双方的生活满意度，但也通过矛盾心理产生间接影响。
本研究采用对偶方法评估痴呆症护理中的矛盾心理。研究结果揭示了夫妻在应对早期 AD 时所经历的矛盾情绪，确定了这种矛盾心理的来源，并阐明了可以促进双方积极结果的对偶干预措施的发展。
