Kuo Li-Min, Wang Ching-Lin, Huang Huei-Ling, Hsu Wen-Chuin, Shyu Yea-Ing L
Department of Gerontological Health Care, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Department of Long-Term Care and Health Management, Cheng Shiu University, Kaohsiung, Taiwan.
Int J Ment Health Nurs. 2025 Feb;34(1):e13459. doi: 10.1111/inm.13459. Epub 2024 Oct 27.
Family caregivers of persons with mild cognitive impairment attempt to understand the behavioural and functional changes exhibited by their relative. However, how caregivers respond to initial changes and changes over time has not been explored. The purpose of this qualitative study was to explore the experience of family caregivers responding to changes in their relative's memory, behaviours, and physical functions over 2 years. Eleven family caregivers of a relative with mild cognitive impairment were purposively recruited from neurological clinics in Taiwan. Face-to-face semi-structured interviews were conducted within 6-months of referral; three follow-ups were conducted at 6-month intervals. Content analysis of 41 transcribed audio-recorded interviews revealed the longitudinal changes in their relative with cognitive impairment was made caregiving challenging. Three themes described the challenges: (1) Changes related to their relative's cognitive impairment, which included increases in mood fluctuations, erratic behaviours, and reductions in physical abilities; (2) changes in their relative's comorbidities, which included adapting to new symptoms and treatments for a chronic disease, monitoring medication adherence and drug interactions; and (3) changes in caregiver burden, which increased levels of stress, uncertainty, and anxiety resulting in greater role strain. Caregiving became more challenging with time, especially caregivers whose relative developed dementia during the study period. These findings offer insight into the trajectory of the experience of family caregivers attempting to understand changes in cognition, behaviours, and physical functions for their relative with mild cognitive impairment over 2 years, which could help mental healthcare providers develop support services to reduce caregiver role strain.
轻度认知障碍患者的家庭照顾者试图理解其亲属所表现出的行为和功能变化。然而，照顾者如何应对最初的变化以及随时间推移的变化尚未得到探讨。这项定性研究的目的是探究家庭照顾者在两年时间里应对其亲属记忆、行为和身体功能变化的经历。从台湾的神经科诊所中有意招募了11名轻度认知障碍患者的家庭照顾者。在转诊后的6个月内进行了面对面的半结构化访谈；每隔6个月进行三次随访。对41份转录的录音访谈进行内容分析后发现，亲属认知障碍的纵向变化给照顾带来了挑战。三个主题描述了这些挑战：（1）与其亲属认知障碍相关的变化，包括情绪波动加剧、行为不稳定以及身体能力下降；（2）其亲属共病情况的变化，包括适应慢性病的新症状和治疗方法、监测药物依从性和药物相互作用；（3）照顾者负担的变化，这增加了压力、不确定性和焦虑水平，导致更大的角色压力。随着时间的推移，照顾变得更具挑战性，尤其是那些亲属在研究期间患上痴呆症的照顾者。这些发现为家庭照顾者在两年时间里试图理解其轻度认知障碍亲属的认知、行为和身体功能变化的经历轨迹提供了见解，这有助于精神卫生保健提供者开发支持服务以减轻照顾者的角色压力。
