Early community-based service utilization and its effects on institutionalization in dementia caregiving
Early community-based service utilization and its effects on institutionalization in dementia caregiving
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DOI：
10.1093/geront/45.2.177
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发表时间：
2005-04-01
期刊：
影响因子：
5.7
通讯作者：
Newcomer, R
中科院分区：
文献类型：
--
作者：
Gaugler, JE;Kane, RL;Newcomer, R
目的：本研究试图确定是否利用社区为基础的长期护理服务早期的痴呆症患者的职业生涯延迟时间养老院安置（调整痴呆症的严重程度）。设计和方法：依靠从美国八个集水区招募的4，761名痴呆症护理人员的数据，并在3年内进行了随访，进行了考克斯比例风险模型，该模型考虑了压力过程的关键组成部分（例如，护理环境、主要客观和主观压力源以及资源）、持续时间和基于社区的长期护理使用。结果如下：对考克斯回归模型中交互作用项的分析发现，那些在痴呆症治疗生涯早期使用家庭帮助服务的人更有可能推迟机构化。含义：研究结果表明，早期社区为基础的服务使用的实际重要性和成本效益的影响，他们强调的作用，时机时，一个是概念化的压力扩散在痴呆症的治疗生涯。
Purpose: The present study attempts to determine whether utilizing community-based long-term-care services early in the dementia caregiving career delays time to nursing home placement (adjusting for severity of dementia). Design and Methods: With a reliance on data from 4,761 dementia caregivers recruited from eight catchment areas in the United States and followed over a 3-year period, a Cox proportional hazards model was conducted that considered key components of the stress process (e.g., context of care, primary objective and subjective stressors, and resources), duration, and community-based long-term-care use. Results: An analysis of interaction terms in the Cox regression model found that those individuals who utilized in-home help services earlier in their dementia caregiving careers were more likely to delay institutionalization. Implications: The findings suggest the practical importance and cost-effectiveness implications of early community-based service use, and they emphasize the role of timing when one is conceptualizing the proliferation of stress in the dementia caregiving career.