Browning Wesley R, Yildiz Mustafa, Maxwell Christopher D, Sullivan Tami P, Yefimova Maria, Hernandez Chilatra Jessica A, Pickering Carolyn E Z
Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.
School of Criminal Justice, Michigan State University, East Lansing, Michigan, USA.
Gerontologist. 2024 Oct 1;64(10). doi: 10.1093/geront/gnae108.
Family conflict is a stressor for dementia family caregivers, yet its impact may differ based on the relationship between caregivers and their recipients. This study's objectives were to categorize caregivers into groups based on family conflict, examine whether the relationship to the recipient influences group membership, and determine whether these groups are associated with engaging in abusive and neglectful behaviors.
This national, cross-sectional study of 453 dementia family caregivers used latent class analysis to generate groups based on family conflict and abuse accusations. A multinomial logistic regression determined if relationship type (i.e., being a spouse, child, or grandchild to the care recipient or having a nontraditional relationship) predicted group membership. Groups were examined as predictors of abusive and neglectful behaviors using analysis of variance.
A 4-class solution emerged as the best fit: 3 groups with varying probabilities of family conflict and 1 group with elevated probabilities of abuse and neglect accusations. Relationship typed predicted membership in these classes. Group membership predicted abusive and neglectful behaviors.
Adult children were more likely to experience high amounts of family conflict, whereas nontraditional caregivers were less likely to experience abuse and neglect accusations. Membership in the accusations group was a unique risk factor for abusive and neglectful behaviors. These findings support the need for continued investigation of family conflict in dementia caregivers. They also call to examine how family relationship types, including nontraditional family structures, influence caregiving outcomes.
家庭冲突是痴呆症患者家庭照料者面临的一种压力源，但其影响可能因照料者与其照料对象之间的关系而有所不同。本研究的目的是根据家庭冲突将照料者进行分组，考察与照料对象的关系是否会影响分组情况，并确定这些分组是否与虐待和忽视行为有关。
这项针对453名痴呆症家庭照料者的全国性横断面研究，采用潜在类别分析根据家庭冲突和虐待指控来划分组别。多项逻辑回归分析确定关系类型（即作为照料对象的配偶、子女、孙辈或具有非传统关系）是否能预测分组情况。使用方差分析将分组作为虐待和忽视行为的预测因素进行考察。
四类分组方案最为合适：3组家庭冲突概率各异，1组虐待和忽视指控概率较高。关系类型可预测这些类别的分组情况。分组情况可预测虐待和忽视行为。
成年子女更有可能经历大量家庭冲突，而非传统照料者遭受虐待和忽视指控的可能性较小。处于指控组是虐待和忽视行为的一个独特风险因素。这些发现支持继续对痴呆症照料者的家庭冲突进行调查。它们还呼吁研究包括非传统家庭结构在内的家庭关系类型如何影响照料结果。
