痴呆患者照顾者的自我效能感在患者相关损害和照顾者健康相关生活质量间的中介效应

目的探讨痴呆患者家属照顾者的自我效能感在患者相关损害和照顾者健康相关生活质量间的中介效应。方法本研究为横断面研究。采用便利抽样法,选取2015年12月—2019年9月在上海市2所三级甲等医院陪同患者就诊的痴呆患者家属照顾者作为研究对象。采用中国家属照顾者自我效能问卷、简明健康调查量表(SF-36)、阿尔茨海默病相关结果评价量表对其进行问卷调查,采用SPSS 22.0和AMOS 22.0软件进行统计分析,使用Pearson相关分析变量间的相关性,建立结构方程模型检验变量间的关系。结果共291名符合纳入标准的照顾者完成了问卷评估,问卷完成率为100%。痴呆患者的损害评分为(87.13±23.88)分,照顾者的自我效能感总分为(57.49±16.42)分,健康相关生活质量躯体健康总评分为(41.33±9.71)分,心理健康总评分为(48.85±7.69)分。Pearson相关分析结果显示,除获取支持维度的自我效能感以外,患者痴呆相关损害总分与照顾者自我效能感总分及各照顾行为维度的自我效能感呈正相关(P<0.05);患者痴呆相关损害总分与照顾者躯体健康总评分、心理健康总评分均呈正相关(P<0.01);照顾者自我效能感总分及各照顾行为维度的自我效能感与照顾者躯体健康总评分、心理健康总评分均呈正相关(P<0.01)。照顾者自我效能感在患者的痴呆相关损害与照顾者躯体健康和心理健康相关生活质量之间起部分中介作用,中介效应分别占总效应的29.79%和43.67%。结论患者的痴呆相关损害可以通过直接作用影响照顾者的健康相关生活质量,也可以通过照顾者自我效能感间接影响照顾者的健康相关生活质量,因此可以通过提升照顾者自我效能感,减少痴呆相关损害对照顾者健康相关生活质量的影响。

Mediating effects of self-efficacy of family caregivers of dementia patients between patient-related impairment and caregivers'health-related quality of life

Objective To explore the mediating effect of self-efficacy of family caregivers of dementia patients between patient-related impairment and caregivers'health-related quality of life.Methods This study was a aross-sectional study.Using the convenient sampling method,family caregivers of dementia patients who accompanied patients in two ClassⅢGrade A hospitals in Shanghai from December 2015 to September 2019 were selected as the research objects.Self-Efficacy Questionnaire for Chinese Family Caregivers(SEQCFC),the MOS 36-item Short Form Health Survey(SF-36)and the Chinese Version of the Relevant Outcome Scale for Alzheimer's disease(CROSA)were used to conduct the questionnaire survey.SPSS 22.0 and AMOS 22.0 software were used for statistical analysis,Pearson correlation was used to calculate the correlation between variables and structural equation model was established to test the relationship between variables.Results A total of 291 caregivers who met the inclusion criteria completed the questionnaire assessment,and the completion rate of the questionnaire was 100%.The impairment score of dementia patients was(87.13±23.88),the total score of self-efficacy of care givers was(57.49±16.42),the overall physical health score of health-related quality of life was(41.33±9.71)and the total score of mental health was(48.85±7.69).The results of Pearson correlation analysis showed that in addition to the self-efficacy of the support dimension,the total score of the patients'dementia-related impairment was positively correlated with the total score of the caregivers'self-efficacy and the self-efficacy of the care giving behavior dimensions(P<0.05).The total score of dementia-related impairment of patients was positively correlated with the total score of physical health and the total score of mental health of caregivers(P<0.01).The total score of caregivers'self-efficacy and the self-efficacy of each dimension of caregiving behavior were positively correlated with the total score of physical health and mental health of caregiver(P<0.01).Caregivers'self-efficacy was a partial mediator between dementia-related impairment and physical and mental health related quality of life of caregivers,and the mediation effect accounted for 29.79%and 43.67%of the total effect,respectively.Conclusions The dementia-related damage of patients can directly affect the caregivers'health-related quality of life and it can also indirectly affect the caregivers'healthrelated quality of life through the caregivers'sense of self-efficacy.Therefore,it can reduce effects of dementiarelated impairment on health-related quality of life of caregivers by improving caregivers'sense of self-efficacy.