养老机构老年痴呆患者照护者的负担情况及影响因素分析

于国强; 刘旭英; 孙婧妍; 尹瑞楠; 曹燚; 吴壮; 王婷; 刘杨月; 冯秋菊; 滕金艳

doi:10.16766/j.cnki.issn.1674-4152.003814

养老机构老年痴呆患者照护者的负担情况及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003814

于国强^{1, 2},
刘旭英¹,
孙婧妍¹,
尹瑞楠¹,
曹燚²,
吴壮²,
王婷²,
刘杨月²,
冯秋菊²,
滕金艳^3, ,

1.
黑龙江中医药大学第二临床医学院，黑龙江哈尔滨 150040
2.
黑龙江中医药大学附属第二医院针灸科，黑龙江哈尔滨 150001
3.
湖北省中医院(湖北中医药大学附属医院，湖北时珍实验室)针灸科，湖北武汉 430000

基金项目:

国家自然科学基金面上项目 82074539

黑龙江省卫生健康委科研项目 20211212010322

详细信息

通讯作者:
滕金艳，E-mail：503736143@qq.com

中图分类号: R749.16
计量
- 文章访问数: 84
- HTML全文浏览量: 30
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-06
- 网络出版日期: 2025-01-20

Analysis of the burden and influencing factors affecting caregivers of elderly dementia patients in nursing homes

1.
The Second Clinical School of Heilongjiang University of TCM, Harbin, Heilongjiang 150040, China

摘要

摘要: 目的研究黑龙江省养老机构中老年痴呆患者照护者的负担情况，从患者与其照护者2个角度分析照护者负担的影响因素。方法采用整群便利随机抽样法，从哈尔滨市和绥化市两地4所养老机构筛选2023年3—9月入住符合纳入及排除标准的老年痴呆患者及其照护者各157人为研究对象。应用自制老年人一般情况调查量表、临床痴呆评定量表(CDR)、老年痴呆生活质量量表(QOL-AD)、简易老年抑郁量表(GDS-15)、Zarit照顾者负担量表(ZBI)展开调查，采用多元线性回归分析照护者负担的影响因素。结果 157名照护者ZBI得分为(28.25±12.55)分；照护者负担与QOL-AD评分呈负相关关系(r=-0.191，P＜0.05)；痴呆患者的睡眠时间、患者的痴呆程度、患者有无抑郁、照护者性别、照护者培训与否均为痴呆患者照护者负担的独立影响因素(P＜0.05)，其对照护者负担的总体贡献率为32.5%(F=12.541，P＜0.001)。结论养老机构痴呆照护者普遍存在照护负担，其中，中度负担占比最多(52.23%)，养老机构应多关注照护者的性别，给予女性照护者更多关怀，并积极组织提升照护者业务能力的培训，探索医养结合养老机构的新模式，增加痴呆患者的睡眠时间，改善痴呆患者病情程度和抑郁状态，有助于缓解其照护者的负担。
- 养老机构 /
- 痴呆 /
- 照护者 /
- 负担 /
- 影响因素
Abstract: Objective To investigate the caregiver burden of dementia patients in elderly care institutions in Heilongjiang Province and analyze the influencing factors on caregiver burden from the perspectives of patients and their caregivers. Methods Using the overall convenience random sampling method, a total of 157 dementia patients and their nursing staff were selected from 4 elderly care institutions in Harbin and Suihua from March to September 2023. The self-made elderly general reality survey scale, clinical dementia rating scale (CDR), quality of life-Alzheimer' s disease (QOL-AD), geriatric depression scale-15 (GDS-15), and Zarit caregiver burden interview (ZBI) were used for the survey, and meta regression analysis was conducted to identify influencing factors. Results The caregivers had a ZBI score of (28.25 ± 12.55) points. The caregiver burden is negatively correlated with QOL-AD score (r=-0.191, P<0.05) The sleep duration of dementia patients, the severity of dementia, the presence of depression, the gender of the caregivers, and whether caregivers received formal training are independent influencing factors of caregiver burden for dementia patients. These factors accounted for a total contribution rate of 32.5% to the control group (F=12.541, P<0.001). Conclusion Caregivers of dementia patients in elderly care institutions generally face protection burdens, with severe burdens accounting for the highest proportion (52.23%). Elderly care institutions should pay more attention to the caregiver gender, provide additional care to female caregivers, organize training to improve caregiving skills, explore new models of medical care and elder care, increase the sleep duration of dementia patients, and address the severity of their condition and depression to alleviate caregiver burden.
- Elderly care institutions /
- Dementia /
- Caregivers /
- Burden /
- Influencing factor

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表 1 不同人口学特征痴呆患者的照护者负担比较(x±s，分)

Table 1. Comparison of caregiver burden of dementia patients with different demographic characteristics (x±s, points)

项目	例数	ZBI得分	统计量	P值
年龄			1.747^a	0.083
60~70岁	93	26.71±11.65
＞70岁	64	30.12±12.54
性别			-0.855^a	0.394
女性	69	27.54±12.02
男性	88	29.24±12.62
受教育程度			-1.017^a	0.311
初中以下	133	29.35±12.67
初中以上	24	26.32±11.77
婚姻状况			1.497^a	0.137
已婚	39	25.81±11.04
离婚/丧偶/未婚	118	29.51±12.82
睡眠时间			-4.022^a	＜0.001
＜6 h	105	32.02±14.65
≥6 h	52	22.83±10.68
自主二便			-5.492^a	＜0.001
否	41	40.05±16.02
是	116	26.95±11.96
伴随疾病(种)			1.793^a	0.075
＜3	95	27.36±12.02
≥3	62	31.20±14.65
痴呆程度			7.932^b	0.005
轻度	71	24.62±11.35
中度	50	29.21±13.12
重度	36	35.21±15.95
抑郁情况			3.700^a	0.003
无	122	25.62±10.95
有	35	34.24±15.69
注：^a为t值，^b为F值。

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表 2 不同人口学特征照护者ZBI评分比较(x±s，分)

Table 2. Comparison of ZBI scores of caregivers with different demographic characteristics (x±s, points)

项目	例数	ZBI得分	t值	P值
年龄			3.795	0.002
＜60岁	92	25.98±11.68
≥60岁	65	32.65±14.65
性别			-2.493	0.014
女性	86	30.25±12.24
男性	71	27.65±12.35
受教育程度			-1.529	0.128
高中以下	112	29.65±12.99
高中以上	45	26.25±11.56
婚姻状况			-0.863	0.390
已婚	132	28.98±12.51
离婚/丧偶/未婚	25	26.65±11.66
经济收入			1.686	0.094
＜3 000元	36	31.21±14.02
≥3 000元	121	27.21±12.02
照护关系			-0.689	0.492
亲属	32	29.32±12.85
非亲属	125	27.62±12.35
照料时间			3.523	＜0.001
＜8 h/d	29	22.32±10.25
≥8 h/d	128	32.62±14.95
培训			2.971	0.003
否	133	25.62±11.21
是	24	33.51±15.65
基础疾病(冠心病/糖尿病/脑卒中/高血压)			1.503	0.135
无	76	26.68±11.68
有	81	29.65±12.99

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表 3 养老机构痴呆患者照护者负担独立影响因素的多重线性回归分析

Table 3. Multiple linear regression analysis of independent influencing factors on caregiver burden of dementia patients in elderly care institutions

变量	B	SE	β	t值	P值
常量	22.812	5.129			＜0.001
照护者性别	-6.221	1.042	-0.074	2.511	0.039
照护者培训情况	-9.829	1.206	-0.656	-1.645	0.002
患者睡眠时间	-2.478	0.523	-0.625	-2.321	0.010
患者痴呆程度	3.931	0.915	0.021	2.102	＜0.001
患者抑郁情况	0.162	0.034	0.322	3.965	0.041
注：R²=0.325，调整后R²=0.268，F=12.541，P＜0.001。

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