Wang Yixin, Tian Siwei, Yi Jingxi, Cai Chan, Zhu Yuxin, Shi Chongqing
Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China.
Institute of Nursing Research, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, Hubei Province, China; Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Geriatr Nurs. 2024 Nov-Dec;60:92-98. doi: 10.1016/j.gerinurse.2024.08.017. Epub 2024 Sep 4.
Numerous studies have demonstrated that informal caregivers of people living with dementia (PLWD) have serious adverse psychological problems, but little research has been done on the role of integrating caregivers' various coping resources in reducing psychological effects. Therefore, the current study aimed to investigate the impact of caregivers' internal (self-efficacy and positive coping) and external coping resources (family function and social support) on the family burden and psychological distress.
A cross-sectional study, and a self-designed questionnaire, Family Burden Scale of Disease, Kessler Psychological Distress Scale, General Self-Efficacy Scale, Simplified Coping Style Question, The Family Adaptation, Partnership, Growth, Affection, Resolve Scale and Social Support Rating Scale were completed by 193 pairs of PLWD and caregivers. Partial least squares-structural equation modeling (PLS-SEM) was used to analyze the mediating effects of coping resources.
Self-efficacy, positive coping, family function, and social support respectively mediated the relationship between family burden and psychological distress (β = 0.402, β = 0.059, β = -0.111, β = 0.053; P < 0.05). Besides, the serial mediation effects of self-efficacy and positive coping, family function and social support were also significant (β = 0.104, β = 0.045; P < 0.05).
This study confirmed the mediating role of internal and external coping resources between family burden and psychological distress in caregivers of older PLWD, providing a theoretical basis for promoting the,mental health of caregivers.
众多研究表明，痴呆症患者（PLWD）的非正式照料者存在严重的不良心理问题，但关于整合照料者的各种应对资源在减轻心理影响方面的作用，研究较少。因此，本研究旨在探讨照料者的内部（自我效能感和积极应对）和外部应对资源（家庭功能和社会支持）对家庭负担和心理困扰的影响。
采用横断面研究，由193对PLWD及其照料者完成自行设计的问卷，包括疾病家庭负担量表、凯斯勒心理困扰量表、一般自我效能感量表、简易应对方式问卷、家庭适应、合作、成长、情感、 resolve量表和社会支持评定量表。采用偏最小二乘结构方程模型（PLS-SEM）分析应对资源的中介效应。
自我效能感、积极应对、家庭功能和社会支持分别在家庭负担与心理困扰之间起中介作用（β = 0.402，β = 0.059，β = -0.111，β = 0.053；P < 0.05）。此外，自我效能感与积极应对、家庭功能与社会支持的系列中介效应也显著（β = 0.104，β = 0.045；P < 0.05）。
本研究证实了内部和外部应对资源在老年PLWD照料者的家庭负担和心理困扰之间的中介作用，为促进照料者的心理健康提供了理论依据。
