Russo J, Vitaliano P P
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA.
Exp Aging Res. 1995 Jul-Sep;21(3):273-94. doi: 10.1080/03610739508253985.
The first goal of this study was to examine the occurrence and appraised distress of 20 stressful life events in 175 spouse caregivers (mean age = 68.6) of persons with Alzheimer's disease and 92 age- and gender-matched controls (mean age = 68.5). The second goal was to determine whether, in the caregivers, life stressors were related to burden after controlling for caregiver age, gender, satisfaction with social supports, and care-recipient cognitive and activities of daily living functioning. Caregivers and controls had similar occurrences and appraisals for all but 3 events, which occurred more frequently in caregivers (i.e., "changes in your spouse's health," "changes in your relationship with your spouse," and "changes in the way you friends and family treat you (social relations)"). Only "changes in finances" was appraised as more distressing by caregivers. Six events explained burden in the regressions: "victim of crime," "age discrimination," "serious family arguments (not including spouse)," "change in caregiver's health," "trouble with Medicaid/Medicare or Social Security," and "move to retirement home (associated with less burden)." Age discrimination was related to burden only for the caregivers of the most impaired care recipients. Also, caregivers who experienced health problems and who had been victims of crimes were the most burdened. Caregivers are not immune to problems experienced by older adults, and these problems may exacerbate caregiver burden. Clinicians should consider the overall context of a caregiver's life when evaluating burden.
本研究的首要目标是调查175名阿尔茨海默病患者的配偶照料者（平均年龄 = 68.6岁）和92名年龄及性别匹配的对照组（平均年龄 = 68.5岁）中20种应激性生活事件的发生情况及评估的痛苦程度。第二个目标是确定在照料者中，在控制了照料者的年龄、性别、对社会支持的满意度以及受照料者的认知和日常生活功能后，生活应激源是否与负担相关。除了3种事件外，照料者和对照组在所有事件的发生情况和评估上相似，这3种事件在照料者中更频繁发生（即“配偶健康变化”“与配偶关系变化”以及“朋友和家人对待你的方式变化（社会关系）”）。只有“经济状况变化”被照料者评估为更令人痛苦。回归分析中有6种事件解释了负担情况：“犯罪受害者”“年龄歧视”“严重家庭争吵（不包括与配偶的争吵）”“照料者健康变化”“医疗补助/医疗保险或社会保障问题”以及“搬入养老院（与负担减轻相关）”。年龄歧视仅与受损最严重的受照料者的照料者的负担相关。此外，经历过健康问题和曾是犯罪受害者的照料者负担最重。照料者无法免受老年人所经历问题的影响，而这些问题可能会加重照料者的负担。临床医生在评估负担时应考虑照料者生活的整体背景。
