Patient and caregiver characteristics associated with depression in dementia caregivers

Background: Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) measuring the dependence of activities of daily living of dementia patients are the traditional predictors of caregivers’ depression. The most problematic and stressful event in daily caregiving that caused depression was communication difficulties; however, this factor has not been included either in the ADL or the IADL scale. Besides this, the characteristics of a caregiver may contribute to the arousal in depression as well.||Objectives: The goals of this study were to examine whether the characteristics of patient and caregiver were associated with the depression level of the dementia caregivers as measured by the 20-item Center for Epidemiologic Studies Depression (CES-D) scale. This study also aimed to find out if the use of the recommended communication strategies by the caregivers would lower the probability of suffering from depression.||Results: One hundred and twenty caregivers wereinterviewed. The correlation between patient’s characteristics and caregiver’s depression was weak positive, and it included the dependence of activities of daily living. Caregiver’s characteristics associated with his/her depression included education level and daily caring hours; the correlation was weakly negative and weakly positive respectively.||Conclusion: Depression of dementia caregiver is a complex clinical and social problem, associated with the characteristics of patient and caregiver. Clinicians should keep a watchful eye on caregivers who need to care for their family members with dementia, and multidisciplinary treatments or interventions should be provided for them promptly.||研究背景︰過往的研究慣常採用日常自我照顧能力量表(Activities of Daily Living, ADL)，與工具性日常自我照顧能力量表(Instrumental Activities of Daily Living, IADL)，來預測護理失智症病人所經驗到的抑鬱水平。這些工具嘗試瞭解失智症病者於日常生活中，依賴護理者照顧的程度。可是，有不少護理者指出，於護理工作上，溝通障礙亦可為他們帶來不少壓力，這壓力往往令他們感到抑鬱，而在ADL與IADL內，卻沒有包含測量溝通障礙的項目。除此以外，護理者的背景特徵，亦有可能影響其抑鬱水平。||研究目的︰這次研究的目標，是要探討病者和護理者的背景特徵，與護理者抑鬱水平的關係。同時，研究亦會嘗試瞭解使用一些建議的溝通策略，會否减低出現抑鬱的可能性。研究會透過流行病學研究中心抑鬱症量表(Center for Epidemiological Studies Depression Scale, CES-D)中的二十個項目，來量度護理者的壓力水平。||研究結果︰病者的ADL水平和護理者照顧時間的長短，與護理者的抑鬱水平呈正比關係。同時，護理者的教育水平，與其抑鬱水平成反比關係。||結論︰護理者的心理健康是一個複雜的臨床及社會問題，牽涉到病者與護理者的背景特徵。臨床醫護人員應密切留意家庭護理者的情緒狀况，並於有需要時盡快提供多方面及跨領域的治療及介入。