使用倾向评分匹配分析预测社区居住痴呆患者配偶照顾者睡眠质量。

Hyeon Sik Chu, Hye-Young Jang
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摘要

背景:许多痴呆症患者的家庭照顾者存在睡眠问题和睡眠质量差。照顾患有痴呆症的家庭成员,尤其是配偶,可能会对睡眠产生负面影响。目的:本研究旨在评估残疾患者配偶照护者的睡眠质量,并确定照护对其睡眠质量的影响。方法:对2018年韩国社区健康调查的58050名参与者进行二次分析。为了防止选择偏差,进行了倾向评分匹配分析。采用多元logistic回归分析探讨影响睡眠质量的因素。结果:在获得倾向得分匹配阈值为3:1后,对照组和配偶-照顾者组睡眠不良者比例分别为24.2%和33.3%,差异有统计学意义(χ2 = 11.79, p = .001)。在多重逻辑分析中调整抑郁症状后,在睡眠质量差的风险方面没有发现组间差异(优势比= 1.12,95% CI[0.90, 1.61])。结论/实践启示:本研究结果支持照顾残疾人士配偶的睡眠质量较其非配偶同伴差,抑郁症状的管理对改善照顾残疾人士配偶的睡眠质量很重要。护理干预措施,如光疗和白天暴露在阳光下,既可以改善睡眠质量,又可以减少抑郁症状,可以改善这一弱势照顾者群体的睡眠质量。
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Predictors of Sleep Quality in Spouse Caregivers of Community-Dwelling People With Dementia Using Propensity Score Matching Analysis.

Background: Many family caregivers of people with dementia (PwDs) have sleep problems and poor sleep quality. Sleep may be negatively affected by caring for a family member with dementia, especially a spouse.

Purpose: This study was designed to assess sleep quality in spouse caregivers of PwDs and determine the impact of care provision on their sleep quality.

Methods: A secondary analysis of 58,050 participants in the 2018 Korea Community Health Survey was conducted. To prevent selection bias, a propensity score matching analysis was performed. Multiple logistic regression analysis was conducted to investigate the predictors of sleep quality.

Results: After obtaining a propensity score matching threshold of 3:1, the percentage of poor sleepers was 24.2% in the control group and 33.3% in the spouse-caregiver group, which indicates a significant difference (χ 2 = 11.79, p = .001). After adjusting for depressive symptoms in the multiple logistic analyses, no intergroup difference was found in terms of risk of poor sleep quality (odds ratio = 1.12, 95% CI [0.90, 1.61]).

Conclusions/implications for practice: The findings of this study support that spouse caregivers of PwDs have poorer sleep quality than their nonspouse peers and that management of depressive symptoms is important to improving the sleep quality of spouses providing care to PwDs. Nursing interventions such as light therapy and exposure to sunlight during daytime hours to both improve sleep quality and reduce depressive symptoms can improve sleep quality in this vulnerable caregiver group.

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