Lazaar Najoua, Flurij Floor, van Bruchem-Visser Rozemarijn L, Papma Janne M, Franzen Sanne
Department of Neurology, Erasmus MC University Medical Center Rotterdam, Netherlands.
Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Netherlands.
Dementia (London). 2025 Aug;24(6):1115-1133. doi: 10.1177/14713012251327461. Epub 2025 Apr 14.
In the Netherlands, approximately 800,000 individuals act as informal caregivers for people with dementia. Current policies prioritize care within the home setting, often relying on informal caregivers for support, assisted by care professionals. Given the wide ethnocultural diversity among dementia caregivers in the Netherlands, it is crucial to understand how these cultural differences influence caregiving. Given the emphasis on researching barriers to providing care in literature, this study specifically focused on motivators and facilitators to providing care. We conducted semi-structured interviews, both with caregivers of native Dutch patients ( = 11) and caregivers of patients with a migration background ( = 9), who all provided care at home for patients with dementia. Data was collected using an interview guide and open, axial and selective coding were used to analyze the transcripts of the interviews in Atlas.ti. Four themes were identified. First, culturally shared motivators to providing care emerged, such as having a unique bond with the person with dementia and themes of reciprocity. Second, culture specific perspectives were identified, with Dutch caregivers often spontaneously reporting considering professional care, while culturally diverse caregivers stressed the available network of informal caregivers and their ability to persevere. Third, personal philosophies on life were a driver to provide care for caregivers of native Dutch patients, while religion mainly served as a source of strength in continuing to provide care in the culturally diverse group. Lastly, adult child caregivers benefit from supportive home environments and from using structure and routine in providing care. Our findings show that the decision to provide care often seems driven by reciprocity and the prior quality of the relationship with the person with dementia, contrasting with previous work suggesting that religion is a main reason to provide care. Several recommendations are made how care professionals can take these factors into consideration when assisting caregivers.
在荷兰，约有80万人担任痴呆症患者的非正式照料者。当前政策将家庭环境中的照料置于优先地位，通常依靠非正式照料者提供支持，并由护理专业人员提供协助。鉴于荷兰痴呆症照料者在种族文化方面存在广泛差异，了解这些文化差异如何影响照料工作至关重要。鉴于文献中强调研究提供照料的障碍，本研究特别关注提供照料的动机和促进因素。我们对荷兰本土患者的照料者（n = 11）和有移民背景患者的照料者（n = 9）进行了半结构式访谈，他们均在家中照料痴呆症患者。使用访谈指南收集数据，并运用开放编码、轴心编码和选择性编码对Atlas.ti中的访谈记录进行分析。确定了四个主题。首先，出现了文化上共有的提供照料的动机，例如与痴呆症患者建立独特的联系以及互惠主题。其次，确定了特定文化视角，荷兰照料者经常自发报告考虑专业照料，而文化背景多样照料者则强调非正式照料者的可用网络及其坚持下去的能力。第三，个人生活理念是荷兰本土患者照料者提供照料的驱动力，而宗教在文化背景多样的群体中主要作为持续提供照料的力量源泉。最后，成年子女照料者受益于支持性的家庭环境以及在提供照料时运用条理和常规。我们的研究结果表明，提供照料的决定似乎往往由互惠以及与痴呆症患者先前的关系质量驱动，这与之前认为宗教是提供照料主要原因的研究形成对比。针对护理专业人员在协助照料者时如何考虑这些因素提出了若干建议。
