Medical Comorbidities of Dementia: Links to Caregivers' Emotional Difficulties and Gains
Medical Comorbidities of Dementia: Links to Caregivers' Emotional Difficulties and Gains
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DOI：
10.1111/jgs.16244
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发表时间：
2020-03-01
影响因子：
6.3
通讯作者：
Kales, Helen C.
中科院分区：
文献类型：
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作者：
Polenick, Courtney A.;Min, Lillian;Kales, Helen C.
目的评估8种主要痴呆症(关节炎、癌症、糖尿病、心脏病、高血压、肺部疾病、骨质疏松症和中风)与照顾者对情感照顾困难和照看收益(即照顾角色的好处或回报)的看法之间的关系。设计具有全国代表性的横断面调查，对美国社区居住的痴呆症患者(PLWD)及其共同居住的家庭照顾者进行调查。2011年全国健康和老龄化趋势研究和国家照护研究。PARTICIPANTS总计356名社区居住PLD的家庭照顾者。MEASURENTS照顾者的社会和健康特征，照顾者的社会和健康特征，照顾者的压力，情感照顾者，情感照顾者结果照顾者最常照顾患有关节炎的PLWD(65.5%)，其次是高血压(64.9%)、糖尿病(30.1%)、中风(28.8%)、骨质疏松症(27.1%)、心脏病(23.3%)、癌症(21.5%)和肺部疾病(17.2%)。Logistic回归分析显示，当PLWD被诊断为糖尿病和骨质疏松症时，照顾者报告的情感护理困难的可能性分别是中位数的2.63倍和2.32倍，控制了照顾者的性别、与PLWD的关系(配偶与非配偶)、教育程度、自我评估健康状况以及对日常生活和医疗活动的帮助。当PLWD被诊断为骨质疏松症时，照顾者报告的护理收益低于中位数的可能性也是2.10倍。结论PLWD中合并的健康状况对护理结果有明显的影响。改善护理双方幸福感的临床护理和干预措施应支持护理人员管理痴呆症的医疗合并症。J am Geriatr Soc 68：609-613,2020
OBJECTIVES To evaluate how eight major medical comorbidities of dementia (arthritis, cancer, diabetes, heart disease, hypertension, lung disease, osteoporosis, and stroke) are associated with caregivers' perceptions of emotional caregiving difficulties and caregiving gains (ie, benefits or rewards from the care role).DESIGN Nationally representative cross-sectional surveys of community-dwelling persons living with dementia (PLWDs) and their co-resident family caregivers in the United States.SETTING The 2011 National Health and Aging Trends Study and National Study of Caregiving.PARTICIPANTS Total of 356 co-resident family caregivers of community-dwelling PLWDs.MEASUREMENTS Caregivers' sociodemographic and health characteristics, caregiving stressors, emotional caregiving difficulties, caregiving gains, and chronic health conditions of PLWDs.RESULTS Caregivers most commonly cared for a PLWD with arthritis (65.5%), followed by hypertension (64.9%), diabetes (30.1%), stroke (28.8%), osteoporosis (27.1%), heart disease (23.3%), cancer (21.5%), and lung disease (17.2%). Logistic regressions revealed that caregivers were 2.63 and 2.32 times more likely to report higher than median emotional caregiving difficulties when PLWDs had diagnoses of diabetes and osteoporosis, respectively, controlling for caregiver sex, relationship to the PLWD (spouse vs non-spouse), educational attainment, self-rated health, and assistance with activities of daily living and medical care activities. Caregivers were also 2.10 times more likely to report lower than median caregiving gains when PLWDs had a diagnosis of osteoporosis.CONCLUSION Comorbid health conditions among PLWDs have distinct implications for caregiving outcomes. Clinical care and interventions to improve the well-being of both care dyad members should support caregivers in managing medical comorbidities of dementia. J Am Geriatr Soc 68:609-613, 2020