CAJ | 학술논문

目的：探讨老年期痴呆患者家庭照顾者照顾体验，使用结构方程模型构建并验证照顾者体验模型。方法：选取云南省4所医院349例老年期痴呆患者及其家庭照顾者，以Kramer＇s的照顾者适应模型作为理论框架，提出并验证照顾体验结构方程模型，用于分析和模拟被照顾者病情严重程度、照顾者负担和收获、照顾者积极和消极健康结果之间的关系。结果：被照顾者病情严重程度直接正向影响照顾者负担（β＝0.51，P＜0.05），进而间接影响消极健康结果（β＝0.63，P＜0.05）；被照顾者病情严重程度直接负向影响照顾者收获（β＝－0.33，P＜0.05），进而间接影响积极健康结果（β＝0.75，P＜0.05）；照顾者负担交叉负向影响积极健康结果（β＝－0.13，P＜0.05），但其通径系数绝对值远小于照顾者负担对消极健康结果的通径系数绝对值；照顾者收获对消极健康结果交叉影响无统计学意义。结论：照顾感受由消极方面和积极方面两个方面构成，两个方面的主效应强于交叉效应。
목적：탐토노년기치태환자가정조고자조고체험，사용결구방정모형구건병험증조고자체험모형。방법：선취운남성4소의원349례노년기치태환자급기가정조고자，이Kramer＇s적조고자괄응모형작위이론광가，제출병험증조고체험결구방정모형，용우분석화모의피조고자병정엄중정도、조고자부담화수획、조고자적겁화소겁건강결과지간적관계。결과：피조고자병정엄중정도직접정향영향조고자부담（β＝0.51，P＜0.05），진이간접영향소겁건강결과（β＝0.63，P＜0.05）；피조고자병정엄중정도직접부향영향조고자수획（β＝－0.33，P＜0.05），진이간접영향적겁건강결과（β＝0.75，P＜0.05）；조고자부담교차부향영향적겁건강결과（β＝－0.13，P＜0.05），단기통경계수절대치원소우조고자부담대소겁건강결과적통경계수절대치；조고자수획대소겁건강결과교차영향무통계학의의。결론：조고감수유소겁방면화적겁방면량개방면구성，량개방면적주효응강우교차효응。
Objective:To explore and test a caregiving experience model by Structural Equation Modeling (SEM)in the family caregivers caring for people with dementia in China. Method:Totally 349 elder patients with dementia and their family caregivers were selected and interviewed,using a battery of measures including demo-graphic data of the dyads,impairement of care recipient,caregiver's appraisal of role strain,role gain,negative and positive well-being outcomes. By using the Kramer's caregiver adaptation model as theoretical framework,a care-giving experience model were hypothesized tested by structural equation modeling (SEM). Result:A five-factor model for the caregiving experience was supported by SEM. The model demonstrated that the severity of dementia significantly influenced the caregiver's appraisal of role strain (β=0. 5 1 ,P<0. 05 ),which predicted indirectly neg-ative well-being outcomes of the caregiver (β=0. 63,P<0. 05). On the other hand the caregiver's appraisal of rolegain which was negatively influenced by the severity of parent's dementia (β=-0. 33,P<0. 05),predicted posi-tive well-being outcomes of the caregiver (β=0. 75 ,P<0. 05 ). Conclusion:It suggests that both positive and nega-tive aspects of caregiving experiences could independently impact on the well-being outcomes of adult-child care-givers,and therefore both aspects should be targeted in supportive interventions for family caregivers in China.