痴呆患者家庭照顾者附属病耻感与照顾负担的关系:基于潜在剖面分析

Relationship between affiliated stigma and care burden among family caregivers of dementia patients:based on latent profile analysis

目的 辨别痴呆患者家庭照顾者附属病耻感的潜在类别,并探讨各类别与照顾负担的关系。方法 2021年10月—2022年5月,采用便利抽样法选取河南省5家三级甲等医院神经内科门诊及住院部422名痴呆患者的家庭照顾者为研究对象,使用一般资料问卷、附属病耻感量表和Zarit照顾者负担量表对其进行调查,同时对附属病耻感进行潜在剖面分析。结果 痴呆患者家庭照顾者附属病耻感可分为低附属病耻感组(n=98)、中等附属病耻感组(n=72)和高附属病耻感组(n=252)。照顾者为家庭经济主要来源(OR=1.982,95%CI:-1.698~3.671)、照顾者照顾持续时间≤5年和6~10年(OR=0.277,95%CI:-2.856~1.712、OR=0.362,95%CI:-2.061~1.429)、痴呆患者生活需要帮助(OR=0.025,95%CI:-7.213~-0.181)和照顾者照顾负担得分(OR=4.973,95%CI:0.499~2.708)是痴呆患者家庭照顾者附属病耻感潜在类别的影响因素(P<0.05)。结论 痴呆患者家庭照顾者附属病耻感具有3个潜在类别,医护人员及社区卫生工作者应注重不同照顾者群体的附属病耻感水平,实施有针对性的干预措施,降低其附属病耻感。

Objective To identify the potential categories of affiliated stigma among family caregivers of dementia patients,and to explore the relationship between these categories and the burden of care.Methods From October 2021 to May 2022,422 family caregivers of dementia patients were selected by convenience sampling method from outpatient department and inpa⁃tient department of neurology in 5 grade A hospitals in Henan Province.General information questionnaire,Affiliated Stigma Scale and Zarit Caregiver Burden Scale were used to investigate the associated stigma,and the latent profile of affiliated stigma was analyzed.Results The affiliated stigma of family caregivers of dementia patients could be divided into low affiliated stig⁃ma group(n=98),medium affiliated stigma group(n=72)and high affiliated stigma group(n=252).Caregiver was the main source of family economy(OR=1.982,95%CI:-1.698-3.671),caregiver duration was≤5 years and 6-10 years(OR=0.277,95%CI:-2.856-1.712,OR=0.362,95%CI:-2.011-1.429),dementia patients need help(OR=0.025,95%CI:-7.213-0.181)and caregiver burden score(OR=4.973,95%CI:0.499-2.708)were the influencing factor of the potential category of affiliated stigma among family caregivers of dementia patients(P<0.05).Conclusion There are three latent profile of affiliated stigma in family caregivers of dementia patients.Medical staff and community health workers should pay attention to the level of affiliated stigma in different groups of caregivers and implement targeted interventions to re⁃duce affiliated stigma.