目的 探究阿尔茨海默病(Alzheimer’s disease,AD)患者主要照顾者的预期性悲伤现状,并分析相关影响因素。方法 采用便利抽样法,将180例AD照顾者作为研究对象,采用一般资料调查表、预期性悲伤量表(AGS)、焦虑自评量表(SAS)以及照顾者准备度量表(CPS)进行调查。结果 本研究共发放180份问卷,回收有效问卷167份,有效回收率92.78%。AD照顾者预期性悲伤得分为(80.94 ± 17.25)分;Pearson相关分析显示,AD照顾者的预期性悲伤与焦虑呈正相关(r=0.618,P＜0.05),与照顾者准备度呈负相关(r=-0.472,P＜0.05)。多元线性回归分析显示,主要照顾者的性别(β=5.136,P＜0.001)、与患者的关系(β=-8.304,P＜0.001)、患者病情严重程度(β=6.048,P＜0.001)、焦虑(β=0.419,P＜0.001)、照顾者准备度(β=-0.217,P=0.012)进入回归方程,可以解释预期性悲伤总变异的46.7%。结论 AD照顾者预期性悲伤水平较高,护理工作者应根据照顾者的特点进行干预,以提高照顾者的照护能力以及患者及其照顾者的生活质量。
Abstract
Objective To explore the current status of anticipatory grief and its influencing factors among main caregivers of Alzheimer's disease patients.Methods A total of 180 main caregivers of Alzheimer’s disease patients were investigated by convenience sampling method, using general demographic data questionnaire, Anticipatory Grief Scale (AGS), Self-Rating Anxiety Scale (SAS), and Care preparedness scale (CPS).Results A total of 180 questionnaires were distributed and 167 valid questionnaires were recollected, with an effective recovery rate of 92.78%.The total score of anticipatory grief was (80.94±17.25). Pearson correlation analysis indicated that anticipatory grief was positively correlated with anxiety (r=0.618, P＜0.05), while it was negatively correlated with caregiver readiness (r=-0.472, P＜0.05). The outcome of multiple linear regression analysis indicated that the gender of the main caregivers (β=5.136, P＜0.001), the relationship with patients (β=-8.304, P＜0.001), the severity of patients' diseases (β=6.048, P＜0.001), anxiety (β=0.419, P＜0.001) and care preparedness(β=-0.217, P=0.012) entered the regression equation, which could explain 46.7% of the total variation of anticipatory grief.Conclusions The main caregivers of patients with Alzheimer's disease have a high level of anticipatory grief,so nursing staff should give different intervention schemes according to the characteristics of caregivers, so as to improve the care ability of caregivers and the life quality of patients and their caregivers.
关键词
阿尔茨海默病 /
照顾者 /
预期性悲伤 /
焦虑 /
照顾者准备度
Key words
Alzheimer’s disease /
caregiver /
anticipatory grief /
anxiety /
caregiver preparedness
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参考文献
[1] Zhao L. 2020 Alzheimer’s disease facts and figures [J]. Alzheimer’s Dement, 2020, 16(3): 391-460.
[2] ADC秘书处.“今天礼拜几？”在中国,1500多万人正在遗忘最熟悉的人[EB/OL]. (2021-09-21) [2021-11-3]. https://www.adc.org.cn/index.php/article/527.html.
[3] 于文华, 陆宇晗, 路 潜, 等. 癌症患者主要照顾者预期性悲伤的研究进展 [J]. 中华护理杂志, 2018, 053(6):730-735.
[4] Ming L T, Philip Y, Nan L, et al. Detecting pre-death grief in family caregivers of persons with dementia: measurement equivalence of the Mandarin-Chinese version of Marwit-Meuser caregiver grief inventory [J]. BMC Geriatr, 2018, 18(1): 114.
[5] Treml J, Schmidt V, Nagl M, et al. Pre-loss grief and preparedness for death among caregivers of terminally ill cancer patients: a systematic review [J]. Soc Sci Med, 2021, 284:114240.
[6] Yap J F C, Garcia L L, Alfaro R A, et al. Anticipatory grieving and loss during the COVID-19 pandemic [J]. J Public Health (Oxf), 2021, 43(2): e279-e280.
[7] 康婷婷, 郑 蔚, 王丹丹, 等. 胃癌晚期患者配偶预期性悲伤现状及其对生活质量的影响 [J]. 现代预防医学, 2019, 46(23): 4400-4403,4416.
[8] 辛大君. 晚期癌症患者及其家属悲伤反应研究[D]. 泸州: 西南医科大学, 2016.
[9] 张作记. 行为医学量表手册[M]. 北京: 中华医学电子音像出版社, 2005: 213.
[10] 刘延锦, 王 敏, 董小方. 中文版照顾者准备度量表的信效度研究 [J]. 中国实用护理杂志,2016,32(14): 1045-1048.
[11] Spitznagel M B, Anderson J R, Marchitelli B, et al. Owner quality of life, caregiver burden and anticipatory grief: How they differ, why it matters [J]. Vet Rec, 2021, 188(9): e74.
[12] Pérez-González A, Vilajoana-Celaya J, Guàrdia-Olmos J. Alzheimer's disease caregiver characteristics and their relationship with anticipatory grief [J]. Int J Environ Res Public Health, 2021, 18(16): 8838.
[13] 陈琳霞, 姚国利, 张 萍. 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[J]. 中华健康管理学杂志, 2020, 14(4): 381-385.
[14] 刘燕娜, 李海燕, 黄海英. 儿童血液病主要照顾者预期性悲伤现状及其影响因素[J].护理研究, 2021, 35(03): 526-529.
[15] Cheung D S K, Ho K H M, Cheung T F, et al. Anticipatory grief of spousal and adult children caregivers of people with dementia[J]. BMC Palliat Care, 2018, 17(1): 124.
[16] Fox S, Azman A, Timmons S. Palliative care needs in Parkinson's disease: focus on anticipatory grief in family carers[J]. Ann Palliat Med, 2020, 9(Suppl 1): S34-S43.
[17] 金 芳. 长春市阿尔茨海默病人照顾者负担与焦虑现状及影响因素分析[D]. 长春: 长春中医药大学, 2020.
[18] 李明士, 邓小岚, 葛兆霞. 164例老年痴呆患者主要照顾者哀伤现状及影响因素分析[J]. 护理学报, 2021, 28(2): 52-57.
[19] Glick D R, Motta M, Wiegand D L, et al. Anticipatory grief and impaired problem solving among surrogate decision makers of critically ill patients: a cross-sectional study[J]. Int Crit Care Nurs, 2018, 49: 1-5.
[20] Mozersky J, Davis D S. Living with Alzheimer disease and other types of dementia: stories from caregivers [J]. Narrat Inq Bioeth, 2020, 10(2): 89-93.
[21] Shi J, Huang A, Jia Y, et al. Perceived stress and social support influence anxiety symptoms of Chinese family caregivers of community-dwelling older adults: a cross-sectional study[J]. Psychogeriatrics, 2020, 20 (4): 377-384.
[22] Archbold P G, Stewart B J, Greenlick M R, et al. Mutuality and preparedness as predictors of caregiver role strain[J]. Res Nurs Health, 2010, 13(6):375-384.
[23] Patinadan P V, Tan-Ho G, Choo P Y, et al. Resolving anticipatory grief and enhancing dignity at the end of life:a systematic review of palliative interventions[J]. Death Stud, 2022, 46(2): 337-350.
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