Predicting caregiver burden and depression in Alzheimer's disease
Predicting caregiver burden and depression in Alzheimer's disease
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DOI：
10.1093/geronb/55.1.s2
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发表时间：
2000-01-01
影响因子：
6.2
通讯作者：
Tuokko, H
中科院分区：
文献类型：
--
作者：
Clyburn, LD;Stones, MJ;Tuokko, H
目标。本研究的目的是调查护理人员负担和抑郁的预测因素，包括影响护理结果的客观压力源和中介力量。方法。这项调查基于 1994 年加拿大健康与老龄化研究 (CSHA) 数据库。参与者包括居住在社区或机构的 613 名痴呆症患者及其非正式护理人员。 CSHA 的参与者是通过筛选加拿大各地老年人的大量随机样本来确定的。比较了代表从护理压力源（例如功能限制、干扰行为、患者居住、向护理人员提供的帮助）到护理人员负担和抑郁的四种替代途径的结构方程模型。结果。这些数据最适合一个模型，在该模型中，对护理人员福祉的影响是通过负担评估来调节的。较高频率的令人不安的行为、照顾社区居住的患者以及较低的非正式支持与较高的负担有关，这反过来又导致更多的抑郁症状。表现出更多令人不安的行为和功能限制的患者的护理人员从家人和朋友那里获得的帮助较少，而那些居住在机构中的护理对象的护理人员则获得了更多的非正式支持。讨论。我们的研究结果补充了现有的文献，因为我们使用异常大的参与者样本量并在克服了过去研究的方法学局限性之后测试了照顾者负担的替代模型。结果强调了有效管理干扰行为、为高度受损患者的护理人员提供正式服务且没有非正式支持以及提高负担重的护理人员的应对技能的重要性。
Objectives. The purpose of this study was to investigate the predictors of caregiver burden and depression, including objective stressors and mediation forces influencing caregiving outcomes.Methods. This investigation is based on the 1994 Canadian Study of Health and Aging (CSHA) database. participants were 613 individuals with dementia, living in either the community or an institution, and their informal caregivers. Participants for die CSHA were identified by screening a large random sample of elderly persons across Canada. Structural equation models representing four alternative pathways from caregiving stressors (e.g., functional limitations, disturbing behaviors, patient residence, assistance given to caregiver) to caregiver burden and depression were compared.Results. The data provided the best fit to a model whereby the effects on the caregiver's well-being are mediated by appraisals of burden. A higher frequency of disturbing behavior, caring for a community-dwelling patient, and low informal support were related to higher burden, which in turn led to more depressive symptomatology. Caregivers of patients exhibiting more disturbing behaviors and functional limitations received less help from family and friends, whereas those whose care recipients resided in an institution received more informal support.Discussion. Our findings add to the peexisting Literature because we tested alternative models of caregiver burden using an unusually large sample size of participants and after overcoming methodological limitations of past research. Results highlight the importance of the effective management of disturbing behaviors, the provision of formal services for caregivers with highly impaired patients and no informal support, and the improvement of coping skills in burdened caregivers.