Predictors of Self-Reported Psychosocial Outcomes in Individuals With Dementia
Predictors of Self-Reported Psychosocial Outcomes in Individuals With Dementia
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DOI：
10.1093/geront/gns137
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发表时间：
2013-10-01
期刊：
影响因子：
5.7
通讯作者：
Judge, Katherine S.
中科院分区：
文献类型：
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作者：
Dawson, Nicole T.;Powers, Sara M.;Judge, Katherine S.
目的：从痴呆症患者 (IWD) 的角度来看，我们对疾病经历知之甚少，因为大多数定量研究都集中在代理报告中的 IWD 的社会心理问题。本研究的主要目的是通过痴呆症患者压力过程模型（SPM for IWD）的框架，从 IWD 的角度更好地了解疾病经历对健康的影响。设计和方法：在 IWD 的 SPM 指导下，从 IWD（N = 131）收集有关其疾病经历的自我报告数据，包括主要客观和主观压力源、次要角色和内心压力以及幸福结果。使用多元线性回归，将主要压力源、次要压力以及背景和背景特征输入到每个结果的 3 个预测模型中：焦虑、抑郁和生活质量 (QoL)。结果：每个结果指标出现了三种不同的预测模式。记忆丧失带来的尴尬是焦虑的唯一预测因素，而身体健康压力和角色束缚是抑郁的唯一预测因素。生活质量的独特预测因素包括较低的感知日常生活工具性活动 (IADL) 难度和较高的自我效能。意义：这项研究从 IWD 的角度提供了对疾病经历的宝贵见解，并确定了适合干预的关键领域，例如管理记忆问题的尴尬以及提高自我效能和内在力量。此外，这项研究为将 IWD 纳入研究过程提供了额外的支持，并强调需要在研究结果的临床应用、假设检验和干预效果分析方面进行进一步研究。
Purpose: Little is known about the illness experience from the perspective of individuals with dementia (IWDs), as most quantitative research has focused on IWDs' psychosocial issues from proxy reports. The primary aim of this study was to better understand the impact of the illness experience on wellbeing from the perspective of the IWD through the framework of the Stress Process Model for Individuals with Dementia (SPM for IWDs). Design and Methods: Guided by the SPM for IWDs, self-report data were collected from IWDs (N = 131) about their illness experience, including primary objective and subjective stressors, secondary role and intrapsychic strains, and well-being outcomes. Using multiple linear regression, primary stressors, secondary strains, and background and context characteristics were entered into 3 prediction models for each outcome: anxiety, depression, and quality of life (QoL). Results: Three distinct prediction patterns emerged for each of the outcome measures. Embarrassment about memory loss was the unique predictor of anxiety, whereas physical health strain and role captivity uniquely predicted depression. Unique predictors for QoL included lower perceived instrumental activities of daily living (IADL) difficulty and higher self-efficacy. Implications: This study provided valuable insight into the illness experience from the perspective of the IWD and identified key areas amenable to interventions, such as managing embarrassment about memory problems as well as improving self-efficacy and inner strength. Moreover, this study provided additional support for the inclusion of IWDs in the research process and highlighted the need for further research regarding clinical application of findings, testing of hypotheses, and analyzing efficacy of interventions.