主要照料者与阿尔茨海默病患者沟通现状及影响因素分析

Current situation and influencing factors of communication between main caregivers and patients with Alzheimer′s disease

目的探讨主要照料者与阿尔茨海默病(AD)患者的沟通现状及影响因素。方法采用便利抽样法选取150例AD患者的主要照料者进行问卷调查、量表评定和统计分析。结果沟通问卷总分(55.28±22.55)分,7个沟通维度得分差异无统计学意义(F=0.883,P=0.512),其中沟通认知得分最高(61.69±31.77)分,沟通方式得分最低(42.51±21.31)分。沟通问卷总分与临床痴呆评定量表(CDR)得分(r=-0.192,P=0.019)呈负相关,与神经精神科问卷(NPI)得分(r=0.185,P=0.024)、照料者受教育年限(r=0.164,P=0.047)呈正相关。AD患者不同性别及不同婚姻沟通问卷总分差异有统计学意义(P<0.05)。照护时长、CDR得分、AD患者受教育年限、AD患者婚姻是沟通问卷总分的主要影响因素(R^(2)=0.204)。结论主要照料者与AD患者总体沟通状况不良,尤其缺乏非语言沟通方式;照护时间较短的照料者更需要重视文化程度较高、有配偶患者的沟通交流。

Objective To explore the current situation of communication between main caregivers and the patients with Alzheimer′s disease(AD)and its influencing factors.Methods A total of 150 AD patients and their main caregivers selected by the convenient sampling method conducted the questionnaire survey,scale evaluation and statistical analysis.Results The total score of the communication questionnaire was(55.28±22.55)points,and there was no statistically significant difference in the scores of seven communication dimensions(F=0.883,P=0.512),in which the score of communication cognition was the highest[(61.69±31.77)points],and the score of communication mode was the lowest[(42.51±21.31)points].The total score of communication questionnaire was negatively correlated with the Clinical Dementia Rating(CDR)score(r=-0.192,P=0.019),and positively correlated with the Neuropsychiatric Inventory(NPI)score(r=0.185,P=0.024)and the educational years of the caregivers(r=0.164,P=0.047).There was statistically significant difference in the total score of communication questionnaire between different genders(t=2.212,P=0.030)and different marital statuses(t=2.922,P=0.005).The duration of care,CDR score,educational years of the patients and marital status were the main influencing factors of the communication questionnaire score(R^(2)=0.204).Conclusion The overall communication status between the caregivers and AD patients is poor,especially lack of nonverbal communication mode;the caregivers with shorter care time need to pay more attention to the communication of the patients with higher cultural degree and spouse.