认知症老年人机构护理员压力与应对研究:基于抗逆力的视角

Burdens and Coping Strategies of Formal Caregivers Caring for the Elderly with Dementia:A Perspective of Resilience

作为世界上认知症老年人数最多的国家,中国面临认知症照护的巨大挑战。由于认知症照护的专业性、复杂性和高度依赖性,机构照护需求迅速提高,认知症老年人的机构护理员面临更多的压力,由“风险因素”和“保护性因素”所形塑的抗逆力特征影响着护理员的压力来源与应对策略。护理员与被照护老年人特征及其互动关系构成了内部压力,护理员与老年人家属之间的信任关系和机构管理成为两个重要的外部压力来源。个人特质、精神信念、行为策略和护理员的家庭支持,共同形成了压力的适应与应对策略。在机构照护的建构过程中,亟须反思“照护责任的女性化”,重构照护信任关系在抗逆力策略中的重要作用,同时为护理员建立起完善的社会支持体系。缓解护理员压力并积极应对,是稳定护理员队伍、提高认知症老年人照护质量的重要保障。

As the country with the largest number of older adults with dementia, China is faced with unprecedented challenges in dementia care. In consideration of the complexity, professionality, and high dependency of caring for the elderly with dementia, the burden outweighs the capacity of informal caregivers which leads to the corresponding increment of demand in caring in institutions. While formal caregivers caring for older adults with dementia are exposed to mounting caregiving burdens, the characteristics of resilience composed of “risk factors” and “protective factors” influence the origin of the burden and their coping strategies. The characteristics of caregivers and care recipients and their interactive relationship form the internal burden, while the trust between caregivers and relatives of the elderly as well as the management within institutions are two major elements resulting in the outer burden. Personal characteristics, spiritual beliefs, behavioral strategies, and received family support of formal caregivers together shape their burden adaptation and coping strategies. In the construction of caring for the older adults with dementia in institutions, it is an urgent need to reflect on the “feminization of care”, reconstruct the significance of trust in resilience strategies, and build up a comprehensive social support system for formal caregivers at the same time. Relieving the burden of formal caregivers and responding actively is an important guarantee for stabilizing the team of caregivers and improving the quality of care for the elderly with dementia.