Factors associated with the quality of life in family caregivers of people with dementia in Taiwan

Teng- Yeh, Jian- Su, Chih- Chang
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Abstract

Objectives: Previous studies showed that caregivers of patients with dementia (PWD) have lower quality of life (QoL) due to several clinical factors related to caregivers and their ill relatives. In this study, we intended to assess the associated factors of QoL in caregivers of PWD in Taiwan. Methods: A cross-sectional survey with 270 dyads of PWD and their caregivers was conducted. We assessed family members' depressive symptoms, anxiety, affiliate stigma, care burden, and QoL, and patients' cognition, severity of dementia, self-care, and mobility skills, as well as neuropsychiatry symptoms of PWD. Results: Caregivers' longer years of education were significantly associated with better QoL in environment domains (β = 0.21, p < 0.01), while the children of caregivers had significantly better QoL in physical domains compared to spouses of caregivers (β = 0.28, p < 0.05). Patients with a past history of psychiatric hospitalization (β = 0.11, p < 0.05) and longer caregiving time (β = 0.13, p < 0.05) were significantly related to better QoL in environment domain. High levels of depression were associated with significantly lower QoL in physical health (β = −0.24, p < 0.05) and psychological domains (β = −0.32, p < 0.01), while more anxiety symptoms were related to significantly lower QoL in physical health (β = −0.26, p < 0.01) and environment domains (β = −0.27, p < 0.01). Higher levels of affiliate stigma were significantly related to lower QoL of caregivers in psychological (β = −0.23, p < 0.01), social relationships (β = −0.27, p < 0.01), and environment (β = −0.19, p < 0.05) domains. Higher levels of care burden were significantly related to lower QoL of caregivers in physical health (β = −0.24, p < 0.01) and environment (β = −0.23, p < 0.05) domains. Conclusion: Caregiver's depression, anxiety, affiliate stigma, and care burden were found to play a critical role in maintaining QoL of family caregivers. We suggest developing effective programs as a direction of future intervention for PWD to improve their QoL.
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台湾失智症患者家庭照护者生活品质之相关因素
目的:以往的研究表明,痴呆症患者(PWD)护理者的生活质量(QoL)较低,原因是与护理者及其患病亲属相关的多种临床因素。本研究旨在探讨影响残疾照护者生活品质的相关因素。方法:对270对PWD患者及其护理人员进行横断面调查。我们评估了家庭成员的抑郁症状、焦虑、附属耻辱感、护理负担和生活质量,以及患者的认知、痴呆的严重程度、自我护理和行动技能,以及PWD的神经精神症状。结果:照料者受教育年限越长,照料者在环境领域的生活质量越好(β = 0.21, p < 0.01),照料者子女在身体领域的生活质量显著优于照料者配偶(β = 0.28, p < 0.05)。有精神疾病住院史(β = 0.11, p < 0.05)和较长的护理时间与环境领域较好的生活质量显著相关(β = 0.13, p < 0.05)。抑郁水平高与生理健康(β = - 0.24, p < 0.05)和心理领域(β = - 0.32, p < 0.01)的生活质量显著降低相关,焦虑症状多与生理健康(β = - 0.26, p < 0.01)和环境领域(β = - 0.27, p < 0.01)的生活质量显著降低相关。在心理(β = - 0.23, p < 0.01)、社会关系(β = - 0.27, p < 0.01)和环境(β = - 0.19, p < 0.05)领域,亲缘耻辱感水平升高与照顾者生活质量降低显著相关。照料负担加重与照料者在身体健康(β = - 0.24, p < 0.01)和环境(β = - 0.23, p < 0.05)方面的生活质量降低显著相关。结论:照顾者抑郁、焦虑、伴随病耻感和照顾负担对维持家庭照顾者生活质量起关键作用。我们建议制定有效的计划作为未来干预的方向,以改善残疾人的生活质量。
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