A Comparison of Primary and Secondary Caregivers of Persons With Dementia
A Comparison of Primary and Secondary Caregivers of Persons With Dementia
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DOI：
10.1037/pag0000380
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发表时间：
2020-02-01
影响因子：
3.7
通讯作者：
Mateos, Raimundo
中科院分区：
文献类型：
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作者：
Goncalves-Pereira, Manuel;Zarit, Steven H.;Mateos, Raimundo
在世界范围内，有 2 名或更多亲属参与痴呆症患者的非正式护理的情况很常见。然而，对主要和次要照顾者的比较很少，对同一个人照顾者的比较就更少了。我们的研究旨在对比这两种护理经历。我们在一项非随机横断面研究中比较了同一痴呆症患者的 61 名主要家庭照顾者和 61 名次要家庭照顾者的 2 个相关样本。护理人员的主要结果评估是扎里特负担访谈（针对主观负担）、一般健康问卷（针对心理困扰）和护理积极方面量表。我们控制了照顾者变量（例如人口统计、照顾安排、社会支持、连贯感）和痴呆症的神经精神症状。主要照顾者的主观负担高于二级照顾者 (p = .013)，但照顾的积极方面没有差异 (p = .150)。主要和次要照顾者的临床相关水平的心理困扰较高，但组间无统计学显着差异 (p = .456)。研究结果表明，尽管主要照顾者面临困难，次要照顾者也可能经历临床上显着的痛苦。因此，应更系统地满足他们的援助和支持需求。这些发现呼吁对痴呆症采取系统性的、以家庭为中心的干预措施，解决每个人提供或可能提供的支持，以及每个人可能感受到的心理困扰。
Having 2 or more relatives involved in the informal care of people with dementia is frequent worldwide. There are, however, few comparisons of primary and secondary caregivers and even fewer of those who are caring for the same person. Our study aimed to contrast these 2 experiences of caregiving. We compared 2 related samples of 61 primary and 61 secondary family caregivers of the same persons with dementia in a nonrandomized cross-sectional study. Caregivers' main outcome assessments were the Zarit Burden Interview (for subjective burden), the General Health Questionnaire (for psychological distress), and the Positive Aspects of Caregiving scale. We controlled for caregiver variables (e.g., demographics, caregiving arrangements, social support, sense of coherence) and the neuropsychiatric symptoms of dementia. Subjective burden was higher in primary than secondary caregivers (p = .013), but positive aspects of caregiving did not differ (p = .150). Psychological distress was high at clinically relevant levels in primary and secondary caregivers, without statistically significant differences between groups (p = .456). The findings demonstrate that notwithstanding the difficulties faced by primary caregivers, secondary caregivers may also experience clinically significant distress. Therefore, their needs for assistance and support should be addressed more systematically. These findings call for systemic family-focused interventions in dementia that address the support each person provides or might provide, as well as the psychological distress each person may feel.