中晚期阿尔茨海默病家庭主要照顾者预期性悲伤现状及其影响因素

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目的:分析中晚期阿尔茨海默病(AD)家庭主要照顾者预期性悲伤现状及其影响因素。方法:选取2018年8月至2019年9月在绍兴市第七人民医院就诊的160例中晚期AD家庭主要照顾者为研究对象,调查照顾者的性别、年龄、受教育程度、与患者关系、参与照顾原因及患者患病的时间、合并的病种和生活自理程度,采用预期性悲伤量表比较不同特征照顾者预期性悲伤水平,Pearson相关分析照顾者预期性悲伤和照顾者负担的相关性,并进一步探讨影响照顾者预期性悲伤的因素。结果:中晚期AD家庭主要照顾者预期性悲伤得分为(83.88±17.21)分,单因素分析显示,女性的预期性悲伤水平高于男性(n t=12.337)、配偶的预期性悲伤高于儿女和其他家属(n F=10.940)、基于责任、义务和没有他人照顾原因的预期性悲伤高于基于乐意照顾原因(n F=4.501)、患者患病的时间为5~10年的照顾者的预期性悲伤高于<2年和2~4年的照顾者(n F=6.014)、患者合并其他疾病≥3种照顾者的预期性悲伤高于合并其他疾病≤1和2种的照顾者、患者生活无法自理照顾者的预期性悲伤高于大部分不能自理和部分自理患者(n F=5.712);中晚期AD主要照顾者负担得分为(50.19±12.61)分,Pearson相关分析显示,照顾者的预期性悲伤与照顾者负担呈正相关(n r=0.581,n P<0.001);多元回归分析显示,照顾者的性别、与患者的关系、患者患病的时间、生活自理程度和照顾者的照顾负担是中晚期AD家庭照顾者预期性悲伤的主要影响因素(均n P<0.05)。n 结论:中晚期AD家庭主要照顾者存在较为严重的预期性悲伤,并且受到照顾者的性别、照顾负担、与患者的关系及患者患病时间及生活自理程度的影响。“,”Objective:To investigate the status of anticipatory grief among primary caregivers of families with advanced Alzheimer′s disease (AD) and analyze the influencing factors.Methods:A total of 160 primary caregivers in the families of AD patients in the middle and late stage who were treated in Shaoxing Seventh People′s hospital from August 2018 to September 2019 were selected as research subjects to investigate caregivers′ gender, age, education level, relationship with patients, reasons for taking care of patients, and the patients′ time of illness, combined diseases, and self-care ability. Anticipatory Grief Scale was used to compare the anticipatory grief level (AGL) of caregivers with different characteristics, and Pearson correlation analysis was used to analyze the correlation between the anticipatory grief and burden of caregivers, with a further exploration of the factors affecting caregivers′ anticipatory grief.Results:The anticipatory grief score of primary caregivers of families with AD patients in the middle and late stage was (83.88±17.21). Single factor analysis showed the following facts: the AGL of female caregivers was higher than that of males (n t =12.337, n P<0.05); the AGL of spouses was higher than that of children and other family members (n F=10.940); the AGL showed in caretaking based on willingness was lower than that based on responsibility and obligation, and the reason was because other people were available (n F=4.501); the AGL of caregivers of patients with 5-10 years of illness was higher than that of those with 2-4 years of illness (n F=6.014); the AGL of caregivers of patients with more than 3 kinds of other diseases was higher than that of those with less than 1 and 2 kinds of other diseases; the AGL of caregivers of patients with no self-care ability was higher than that of those of patients who lost partial or most self-care ability (n F=5.712). The burden score of primary caregivers of patients in the middle and late stages of AD was (50.19±12.61). Pearson correlation analysis indicated that the anticipatory grief of caregivers was positively correlated with their burden of care (n r=0.581, n P<0.001), and multiple regression analysis showed that the caregivers′ gender and relationship with patients, patients′ time of illness, and capacity of self-care, and the caregivers′ burden are the main factors influencing the anticipatory grief of caregivers in families of patients in the middle and late stages of AD (alln P<0.05).n Conclusion:There exists serious anticipatory grief among primary caregivers in families of patients in the middle and late stages of AD. The main influencing factors include caregivers′ gender, burden of care, relationship with patients, patients′ time of illness, and self-care capacity. Health management should be enhanced to improve the quality of life of the primary caregivers of patients in the middle and late stages of AD.
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