Coping, subjective burden and anxiety among family caregivers of older dependents
Coping, subjective burden and anxiety among family caregivers of older dependents
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DOI：
10.1111/jocn.12561
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发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Frias-Osuna, Antonio
中科院分区：
文献类型：
--
作者：
del-Pino-Casado, Rafael;Perez-Cruz, Margarita;Frias-Osuna, Antonio
目的和目标。探讨焦虑与压力源、应对方式和主观负担之间的关系，并有助于确定老年家属家庭照顾者焦虑的相关因素。背景。尽管有研究分析了与照顾者焦虑相关的因素，但没有足够的证据证明这一问题。横断面设计.本研究以140位家庭照顾者为研究对象，采用描述性统计、相关系数及路径分析等方法进行资料分析。采用社会人口学资料和多个量表（Barthel指数、简明精神状态问卷、Cummings神经精神量表、简明科普、照顾者压力指数和汉密尔顿焦虑量表）收集数据。结果压力源（精神和心理症状和日常生活的辅助活动的数量），情绪集中的应对，功能失调的应对和主观负担与更大的焦虑。主观负担在精神症状和心理症状对焦虑的影响中起中介作用，在功能失调应对对焦虑的影响中起部分中介作用。压力源、功能失调应对和主观负担是焦虑的相关因素。支持主观负担在功能失调应对与焦虑关系中的中介作用。功能失调应对对焦虑的影响与压力源无关，与临床实践相关。这些结论为老年家属照顾者的护理干预提供了几点建议：（1）压力源、功能失调应对和主观负担可用于临床实践，以早期发现和早期干预焦虑;（2）为防止主观负担和焦虑，应通过问题解决，积极再评价，自信和控制消极思想;（3）无论压力源的水平和/或缓解的可能性如何，应对功能失调的个人都应系统地制定这些干预措施。
Aims and objectives. To investigate relationships between anxiety and stressors, coping and subjective burden and to contribute to defining factors related to anxiety among family caregivers of older dependents.Background. Despite the studies analysing factors related to anxiety in caregivers, there is not enough evidence about this issue.Design. Cross-sectional design.Methods. Data from 140 family caregivers (convenience sample) were analysed using descriptive statistics, correlation coefficients and path analysis. Socio-demographic data and several scales (Barthel Index, Short Portable Mental Status Questionnaire, Cummings Neuropsychiatric Inventory, Brief COPE, Caregiver Strain Index and Hamilton Anxiety Rating Scale) were used to collect data. Results. Stressors (psychiatric and psychological symptoms and number of assisted activities of daily living), emotion-focused coping, dysfunctional coping and subjective burden were related to greater anxiety. Subjective burden mediated the effects of psychiatric and psychological symptoms on anxiety and partially mediated the effects of dysfunctional coping on anxiety.Conclusions. Stressors, dysfunctional coping and subjective burden were identified as factors related to anxiety. The mediating role of subjective burden in the relationship between dysfunctional coping and anxiety was supported. The effect of dysfunctional coping on anxiety was independent of the stressors.Relevance to clinical practice. These conclusions justify several recommendations regarding nursing interventions for family caregivers of older dependents: (1) stressors, dysfunctional coping and subjective burden can be used in clinical practice for early detection of and early intervention for anxiety; (2) to prevent subjective burden and anxiety, approach-coping skills should be promoted through interventions such as problem-solving, positive reappraisal, assertiveness and control of negative thoughts; (3) these interventions for dysfunctional coping should be systematically developed for individuals with dysfunctional coping regardless of the level of stressors and/or the possibility of respite.