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德国区域性痴呆症护理网络:一年随访时照顾者负担的变化及其相关因素。

Regional dementia care networks in Germany: changes in caregiver burden at one-year follow-up and associated factors.

机构信息

German Center for Neurodegenerative Diseases e. V. (DZNE) site Witten,Postfach 62 50,Stockumer Str. 12,58453 Witten,Germany.

Health Care Research,University of Bremen,Department 11,Human and Health Sciences,Postfach 330440,28334 Bremen,Germany.

出版信息

Int Psychogeriatr. 2017 Jun;29(6):991-1004. doi: 10.1017/S1041610217000126. Epub 2017 Mar 2.

Abstract

BACKGROUND

Recently, regional dementia care networks (DCNs) have been established in Germany to provide timely support for persons with dementia (PwDs) and their families. There is a lack of research in this setting. This study was conducted to describe the burden experienced by informal caregivers over the course of one year when utilizing a DCN and the factors affecting potential changes in caregiver burden during that time.

METHODS

The study was part of the DemNet-D project, a multi-center observational study of DCNs in Germany. Standardized questionnaires were administered during face-to-face interviews at baseline and at a one-year follow-up with PwDs and their informal caregivers who used a DCN. Based on qualitative data, four DCN governance types were identified and used in a multivariate analysis of burden categories.

RESULTS

A total of 389 PwD-informal caregiver dyads completed the follow-up assessment. At follow-up, the dyads reported significantly lower scores for burden in relation to practical care tasks, conflicts of need, and role conflicts. This change was associated with the PwD-caregiver relationship, the caregiver's gender and health status, and the PwD's socio-economic status. The governance structure of the DCNs was associated with change in one of the four burden categories.

CONCLUSIONS

Our data provide the first indications that different governance structures of DCNs seem to be similarly well suited to support network users and might contribute to reducing caregiver burden. However, further studies set in DCNs examining factors that mediate changes in burden are needed to draw strong conclusions regarding the effectiveness of DCNs. Gender differences and the PwD-caregiver relationship should be considered by DCN stakeholders when developing support structures.

摘要

背景

最近,德国建立了区域性痴呆症护理网络(DCN),为痴呆症患者(PwD)及其家属提供及时的支持。在这方面的研究还很缺乏。本研究旨在描述在使用 DCN 的一年内,非正式照护者所经历的负担,并探讨在此期间影响照护者负担变化的因素。

方法

本研究是 DemNet-D 项目的一部分,该项目是德国 DCN 的一项多中心观察性研究。在基线和一年随访时,通过面对面访谈为使用 DCN 的 PwD 和其非正式照护者进行标准化问卷调查。根据定性数据,确定了四种 DCN 治理类型,并在多变量分析中用于负担类别。

结果

共有 389 对 PwD-非正式照护者完成了随访评估。在随访时,照护者报告在实际护理任务、需求冲突和角色冲突方面的负担显著降低。这种变化与 PwD-照护者关系、照护者的性别和健康状况以及 PwD 的社会经济地位有关。DCN 的治理结构与四个负担类别中的一个变化有关。

结论

我们的数据首次表明,不同的 DCN 治理结构似乎同样适合支持网络用户,并可能有助于减轻照护者的负担。然而,为了就 DCN 的有效性得出强有力的结论,还需要在 DCN 中进一步开展研究,以检验影响负担变化的因素。DCN 的利益相关者在制定支持结构时应考虑性别差异和 PwD-照护者关系。

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