题名

Factors Associated with the Quality of Life in Family Caregivers of People with Dementia in Taiwan

DOI

10.4103/TPSY.TPSY_29_22

作者

Teng-Yin Yeh;Jian-An Su;Chih-Cheng Chang

关键词

caregiver Burden Inventory ; stigma ; the Barthel Index ; WHO Quality of Life-BREF

期刊名称

台灣精神醫學

卷期/出版年月

36卷3期(2022 / 09 / 01)

页次

124 - 130

内容语文

英文

中文摘要

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.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Lin, CY,Chang, CC(2016).Reproducibility and minimal detectable change of internalized stigma of mental illness (ISMI) scale in patients with mental illness.Taiwan J Psychiatry,30,177-184.
    連結:
  2. Lin, CY,Chang, CC,Su, JA(2018).Family stigma stress scale in family caregivers of people with mental illness: reproducibility and minimal detectable change.Taiwan J Psychiatry,32,136-144.
    連結:
  3. (1998).Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL group.Psychol Med,28,551-558.
  4. (1995).The World Health Organization quality of life assessment (WHOQOL). Position paper from the world health organization.Soc Sci Med,41,1403-1409.
  5. Abojabel, H,Werner, P(2019).Exploring family stigma among caregivers of persons with Alzheimer’s disease: the experiences of Israeli-Arab caregivers.Dementia,18,391-408.
  6. American Psychiatric Association(1994).Diagnostic and Statistical Manual of Mental Disorders: DSM-IV.Washington, DC, USA:American Psychiatric Association.
  7. Beck, AT,Epstein, N,Brown, G(1988).An inventory for measuring clinical anxiety: psychometric properties.J Consult Clin Psychol,56,893-897.
  8. Bruvik, FK,Ulstein, ID,Ranhoff, AH(2012).The quality of life of people with dementia and their family carers.Dement Geriatr Cogn Disord,34,7-14.
  9. Chang, CC,Su, JA,Chang, KC(2019).Development of the family stigma stress scale (FSSS) for detecting stigma stress in caregivers of people with mental illness.Eval Health Prof,42,148-168.
  10. Chang, CC,Su, JA,Lin, CY(2016).Using the affiliate stigma scale with caregivers of people with dementia: psychometric evaluation.Alzheimers Res Ther,8,45.
  11. Chang, CC,Su, JA,Tsai, CS(2015).Rasch analysis suggested three unidimensional domains for affiliate stigma scale: additional psychometric evaluation.J Clin Epidemiol,68,674-683.
  12. Chang, CC,Yen, CF,Jang, FL(2017).Comparing affiliate stigma between family caregivers of people with different severe mental illness in Taiwan.J Nerv Ment Dis,205,542-549.
  13. Chang, KC,Lin, CY,Chang, CC(2019).Psychological distress mediated the effects of self-stigma on quality of life in opioid-dependent individuals: a cross-sectional study.PLoS One,14,e0211033.
  14. Che, HH,Lu, ML,Chen, HC(2006)。Validation of the Chinese version of the beck anxiety inventory。Formos J Med,10,447-454。
  15. Cheng, CM,Chang, CC,Wang, JD(2019).Negative impacts of self-stigma on the quality of life of patients in methadone maintenance treatment: the mediated roles of psychological distress and social functioning.Int J Environ Res Public Health,16,1299.
  16. Chou, KR,Jiann-Chyun, L,Chu, H(2002).The reliability and validity of the Chinese version of the caregiver burden inventory.Nurs Res,51,324-331.
  17. Contreras, ML,Mioshi, E,Kishita, N(2021).Factors related to the quality of life in family carers of people with dementia: a meta-analysis.J Geriatr Psychiatry Neurol,34,482-500.
  18. Cummings, JL,Mega, M,Gray, K(1994).The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia.Neurology,44,2308-2314.
  19. Dixit, D,Spreadbury, J,Orlando, R(2021).Quality of life assessments in individuals with young-onset dementia and their caregivers.J Geriatr Psychiatry Neurol,34,426-433.
  20. Enache, D,Winblad, B,Aarsland, D(2011).Depression in dementia: epidemiology, mechanisms, and treatment.Curr Opin Psychiatry,24,461-472.
  21. Farina, N,Page, TE,Daley, S(2017).Factors associated with the quality of life of family carers of people with dementia: a systematic review.Alzheimers Dement,13,572-581.
  22. Ferretti, L,McCurry, SM,Logsdon, R(2001).Anxiety and alzheimer’s disease.J Geriatr Psychiatry Neurol,14,52-58.
  23. Froelich, L,Lladó, A,Khandker, RK(2021).Quality of life and caregiver burden of Alzheimer’s disease among community dwelling patients in Europe: variation by disease severity and progression.J Alzheimers Dis Rep,5,791-804.
  24. Gauthier, S,Rosa-Neto, P,Morais, JA(2021).World Alzheimer Report 2021: Journey through the Diagnosis of Dementia.London, England:Alzheimer’s Disease International.
  25. Häusler, A,Sánchez, A,Gellert, P,Deeken, F,Rapp, MA,Nordheim, J(2016).Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter?.Int Psychogeriatr,28,1857-1866.
  26. Hung, CI,Weng, LJ,Su, YJ,Liu, CY(2006).Depression and somatic symptoms scale: a new scale with both depression and somatic symptoms emphasized.Psychiatry Clin Neurosci,60,700-708.
  27. Janssen, EP,de Vugt, M,Köhler, S(2017).Caregiver profiles in dementia related to quality of life, depression and perseverance time in the European actifcare study: the importance of social health.Aging Ment Health,21,49-57.
  28. Lee, Y,Yang, MJ,Lai, TJ(2000).Development of the Taiwanese depression questionnaire.Chang Gung Med J,23,688-694.
  29. Leung, SO,Chan, CC,Shah, S(2007).Development of a Chinese version of the modified Barthel index – validity and reliability.Clin Rehabil,21,912-922.
  30. Lin, CY,Chang, CC,Wu, TH(2016).Dynamic changes of self-stigma, quality of life, somatic complaints, and depression among people with schizophrenia: a pilot study applying Kernel smoothers.Stigma Health,1,29.
  31. Mahoney, FI,Barthel, DW(1965).Functional evaluation: the Barthel index.Md State Med J,14,61-65.
  32. Mak, WW,Cheung, RY(2008).Affiliate stigma among caregivers of people with intellectual disability or mental illness.J Appl Res Intellect Disabil,21,532-545.
  33. Matsumoto, N,Ikeda, M,Fukuhara, R(2007).Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community.Dement Geriatr Cogn Disord,23,219-224.
  34. Miller, EA,Rosenheck, RA,Schneider, LS(2012).Caregiver burden, health utilities, and institutional service use in Alzheimer’s disease.Int J Geriatr Psychiatry,27,382-393.
  35. Moniz-Cook, E,Vernooij-Dassen, M,Woods, R(2008).A European consensus on outcome measures for psychosocial intervention research in dementia care.Aging Ment Health,12,14-29.
  36. Novak, M,Guest, C(1989).Application of a multidimensional caregiver burden inventory.Gerontologist,29,798-803.
  37. Ory, MG,Hoffman, RR, 3rd,Yee, JL(1999).Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers.Gerontologist,39,177-185.
  38. Prince, M,Bryce, R,Albanese, E(2013).The global prevalence of dementia: a systematic review and metaanalysis.Alzheimers Dement,9,63-75.
  39. Santos, RL,Sousa, MF,Simões-Neto, JP(2014).Caregivers’ quality of life in mild and moderate dementia.Arq Neuropsiquiatr,72,931-937.
  40. Selwood, A,Johnston, K,Katona, C(2007).Systematic review of the effect of psychological interventions on family caregivers of people with dementia.J Affect Disord,101,75-89.
  41. Srivastava, G,Tripathi, RK,Tiwari, SC(2016).Caregiver burden and quality of life of key caregivers of patients with dementia.Indian J Psychol Med,38,133-136.
  42. Su, JA,Chang, CC(2020).Association between family caregiver burden and affiliate stigma in the families of people with dementia.Int J Environ Res Public Health,17,2772.
  43. Takahashi, M,Tanaka, K,Miyaoka, H(2005).Depression and associated factors of informal caregivers versus professional caregivers of demented patients.Psychiatry Clin Neurosci,59,473-480.
  44. Tay, KC,Seow, CC,Xiao, C(2016).Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore.Dementia,15,204-220.
  45. Wang, J,Xiao, LD,He, GP(2014).Family caregiver challenges in dementia care in a country with undeveloped dementia services.J Adv Nurs,70,1369-1380.
  46. Weisman de Mamani, A,Weintraub, MJ,Maura, J(2018).Stigma, expressed emotion, and quality of life in caregivers of individuals with dementia.Fam Process,57,694-706.
  47. Werner, P,Goldstein, D,Buchbinder, E(2010).Subjective experience of family stigma as reported by children of Alzheimer’s disease patients.Qual Health Res,20,159-169.
  48. Werner, P,Mittelman, MS,Goldstein, D(2012).Family stigma and caregiver burden in Alzheimer’s disease.Gerontologist,52,89-97.
  49. Yao, G,Chung, CW,Yu, CF(2002).Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version.J Formos Med Assoc,101,342-351.
  50. Yen, CF,Chen, CC,Lee, Y(2009).Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders.Depress Anxiety,26,1033-1039.
被引用次数
  1. 鍾國彪,謝寧惠,曹汶龍(2023)。失智症家庭照顧者的社會支持與生活品質之相關性研究。台灣公共衛生雜誌,42(1),100-116。