Study on influencing factors of primary caregivers’sanxiety based on structural equation model for community disabled elderly
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摘要: 目的 探讨社区失能老人主要照顾者焦虑的影响因素,分析应对方式、照顾负担、自我效能和社会支持对照顾者焦虑的直接与间接作用,并建立其作用关系模型。 方法 采用自行设计的患者和照顾者一般资料问卷、医学应对方式量表、Zarit照顾者负担量表、一般自我效能感量表、社会支持评定量表和焦虑自评量表于2016年6月-12月对上海市浦东新区金杨社区5个社区440名失能老人及主要照顾者进行调查。建立失能老人照顾者焦虑影响因素模型用AMOS 17.0软件进行分析。 结果 模型数据拟合度良好,结构方程模型分析显示:照顾负担对焦虑有间接正向效应(β=0.384,P<0.01);社会支持对焦虑有直接负向效应(β=-0.053,P<0.01)和间接负向效应(β=-0.590,P<0.01);自我效能对焦虑有直接负向效应(β=-0.070,P<0.01)和间接负向效应(β=-0.374,P<0.01);应对方式对焦虑有直接负向效应(β=-0.706,P<0.01)。 结论 应对方式、自我效能和社会支持均可直接影响照顾者焦虑,照顾负担通过应对方式间接影响照顾者焦虑,自我效能通过照顾负担和应对方式间接影响照顾者焦虑,社会支持通过照顾负担、自我效能和应对方式间接影响照顾者焦虑,因此,社区护士未来应鼓励照顾者应用积极的应对方式,给予针对性的医疗知识和提高照顾技能来增强照顾者的自我效能感,应多角度多方位地给予增强照顾者社会支持系统来最终减轻照顾者焦虑。Abstract: Objective To explore the influencing factors of the community disabled elderly caregivers' anxiety, and to analyze the direct and indirect effects of the coping style, the care burden, the self-efficacy and the social support on the caregiver anxiety, and to establish establish its relationship model. Methods We utilized the self-designed patient and caregiver general information questionnaire, medical coping mode questionnaire (MCMQ), caregiver burden scale (Zarit Burden Interview, ZBI), general self-efficacy scale (GSES), the social support rating scale(SSRS) and Self-Rating Anxiety Scale(SAS) to investigate 440 disabled elderly and primary caregivers from five Jinyang communities, Pudong New District, in Shanghai City. The model of anxiety influencing factors was established and analyzed by AMOS17. 0 software. Results The model data fit well, and the structural equation model analysis showed that the care burden had indirect positive effect on anxiety (β=0.384, P<0.01). Social support had direct negative effect on anxiety (β=-0.053, P<0.01) and indirect negative effect (β=-0.590, P<0.01). Self-efficacy had direct negative effect on anxiety (β=-0.070, P<0.01) and indirect negative effect (β=-0.374, P<0.01). Coping mode had direct negative effect on anxiety (β=-0.706, P<0.01). Conclusion Coping style, self-efficacy and social support can directly affect caregiver anxiety. Care burden indirectly influence caregivers anxiety through coping style. Self-efficacy indirectly affect caregiver anxiety through care burden and coping style. Social support indirectly affect caregiver anxiety through care burden、self efficacy and coping style. Therefore, community nurses should encourage caregivers used positive coping styles, and give specific medical knowledge and improve care skills to enhance the self-efficacy of caregivers, and strengthen caregivers social support system in multi-angle multi-dimensional manner to ultimately alleviate caregiver anxiety in the future.
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Key words:
- Caregiver anxiety /
- Structural equation modeling /
- Coping style /
- Self efficacy /
- Caregiving burden /
- Social support
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