摘要
目的调查阿尔茨海默病(AD)患者照料者焦虑、抑郁状态和睡眠现状并探索其相关影响因素。方法2016年12月-2017年9月,采用横截面调查研究设计,共纳入157例阿尔茨海默病患者及其主要照料者157名。分别采用简明智能精神状态检查(MMSE)、蒙特利尔评估(MoCA)量表、日常生活能力量表(ADL)和神经精神量表(NPI)对AD患者的认知功能、日常生活能力和神经精神行为进行评估。采用一般焦虑量表(GAD-7)、患者健康问卷(PHQ-9)和匹兹堡睡眠量表(PSQI)对AD患者照料者的焦虑、抑郁状态和睡眠状况进行评估。使用Logistic回归分析模型来探索各种因素对AD患者照料者焦虑、抑郁状态和睡眠状况的影响。结果 AD患者MMSE平均分为(17.19±7.58)分,根据临床痴呆分级(CDR):轻度痴呆为61例(38.9%),中重度痴呆96例(61.1%)。AD照料者抑郁评分PHQ-9中位数为4分,焦虑评分GAD-7中位数为3分,15.8%的照料者处于中重度的抑郁焦虑状态(≥10分)。照料者睡眠评价PSQI中位数为8分,76.5%的照料者存在睡眠问题(≥5分)。Logistic回归研究分析显示,导致照料者抑郁和焦虑状态的因素为患者的神经精神NPI评分、患者的日常生活能力ADL评分及单独照料者;导致照料者睡眠质量下降的因素为患者的神经精神NPI评分。结论阿尔茨海默病照料者面临比较普遍的焦虑抑郁状态及睡眠质量下降。患者的神经精神行为异常是导致其照料者焦虑抑郁及睡眠问题的主要影响因素。
Objective To investigate the anxiety,depression and sleep disturbances of caregivers for patients with Alzheimer＇s disease（AD）,and to explore the related influencing factors.Methods From December 2016 to September2017,a cross-sectional survey study design was conducted.157 patients with Alzheimer＇s disease and their primary caregivers were included.The cognitive function,ability of daily living,and neuropsychiatric behavior of AD patients were assessed by the Mini-mental state examination（MMSE）,the Montreal assessment scale（MoCA）,the activities of daily living（ADL）,and the Neuropsychiatric inventory（NPI）respectively.The anxiety,depression and sleep quality of caregivers were evaluated on the generalized anxiety disorder scale（GAD-7）,the patient health questionnaire（PHQ-9）,and the Pittsburgh sleep quality index（PSQI）respectively.Logistic regression analysis models were used to estimate the effects of variables on anxiety,depression,and sleep disturbances of caregivers.Results The mean scores on the MMSE of AD patients was（17.19±7.58）points.According to the clinical dementia rating（CDR）,61 patients（38.9%）had mild dementia and 96 patients（61.1%）had moderate to severe dementia.The median scores on the PHQ-9 and the GAD-7 were 4 points and 3 points respectively.15.8% of caregivers had moderate to severe depression and anxiety（≥10 points）.The median score on the PSQI was 8 points,and 76.5%of caregivers had sleep problems（≥5 points）.Logistic regression analysis showed that the factors which affected caregiver＇s depression and anxiety were the NPI scores,the ADL score and taking care of patient alone.The factors which affected caregiver＇s anxiety were the NPI scores.The factor that caused to the sleep disturbances of caregivers was the NPI scores.Conclusion Anxiety,depression and sleep problems are the main challenges that are faced by caregivers of patients with Alzheimer＇s disease.The abnormal neuropsychiatric behaviors of AD patients are the main relevant factors of the caregiver＇s anxiety,depression and sleep disturbances.
作者
姚春娟
乔凌亚
徐小林
Yao Chunjuan, Qiao Lingya, Xu Xiaolin(Sixth ward , Department of Neurology, Tianjin Huanhu Hospital, Tianjin, 30035)
出处
《护士进修杂志》
2018年第13期1155-1159,共5页
Journal of Nurses Training
基金
天津市应用基础与前沿技术研究计划项目(编号:13JCYBJC22700)
关键词
阿尔茨海默病
照料者
焦虑
抑郁
睡眠质量
心理护理
Alzheimer ＇ s disease
Caregiver
Anxiety
Depression
Sleep quality
Psychological care
