Stressors, Positive and Negative Caregiving Appraisals, and Caregiver Psychological Well-Being: The Moderating Role of Stages of Dementia

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Vivian W. Q. Lou, Yuqi Yan, Nan Lu
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Abstract

Caregiving is a process affected by both caregiver and care recipients and contains both positive and negative experiences. However, there is a lack of theories that capture the impact of the progression of dementia on family caregiving. This study proposed and examined a dementia caregiver process two-factor (DCPT) model. Specifically, we explored (a) the relationship between the severity of caregiving stressors and caregiver psychological well-being, along with the mediating role of positive aspects of caregiving (PAC) and caregiving burden, and (b) the moderating role of stages of dementia. Data were obtained from a two-wave longitudinal data collected from 328 adult–child dementia caregivers in Hong Kong. Multiple group analysis was used to examine the proposed hypotheses. Results show that PAC and burden both significantly mediated the relationship between care recipients’ neuropsychiatric symptoms (NPS) and caregiver depressive symptoms and life satisfaction. Stages of dementia significantly moderated the relationship between PAC and caregiver depressive symptoms, with PAC associated with lesser depressive symptoms only among caregivers of those with middle- or late-stage dementia. In sum, the dementia caregiver process two-factor model proposed in this study was supported by our empirical data. This theory and the study results underscore the importance of both PAC and burden and capture the specificity of the caregiving process in different dementia stages. Findings in this study suggest the need to develop tailored interventions that can better accommodate caregivers with diverse characteristics and adapt to the entire disease trajectory.

压力、积极和消极的护理评价以及护理者的心理健康:痴呆症阶段的调节作用
照护是一个受照护者和受照护者双方影响的过程,其中既有积极的经验,也有消极的经验。然而,目前还缺乏能反映痴呆症进展对家庭护理影响的理论。本研究提出并检验了痴呆症护理过程双因素模型(DCPT)。具体来说,我们探讨了(a)照护压力的严重程度与照护者心理健康之间的关系,以及照护的积极方面(PAC)和照护负担的中介作用;(b)痴呆症阶段的调节作用。数据来自于从香港 328 名成人-儿童痴呆症照护者收集的两波纵向数据。研究采用了多组分析法来检验提出的假设。结果表明,PAC 和负担都能显著调节受照顾者的神经精神症状(NPS)与照顾者抑郁症状和生活满意度之间的关系。痴呆症的分期在很大程度上调节了 PAC 与照顾者抑郁症状之间的关系,只有在中晚期痴呆症患者的照顾者中,PAC 才与较轻的抑郁症状相关。总之,本研究提出的痴呆症照护者过程双因素模型得到了实证数据的支持。这一理论和研究结果都强调了 PAC 和负担的重要性,并捕捉到了不同痴呆症阶段护理过程的特殊性。本研究的结果表明,我们有必要开发量身定制的干预措施,以更好地适应具有不同特征的照护者,并适应整个疾病轨迹。
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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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