CAJ | 학술논문

目的：探究阿尔茨海默病（AD）患者照料者的心理健康状况及其影响因素。方法对AD照料者进行症状自评量表（SCL‐90）、扎瑞特照料负担量表（ZBI）、社会支持评定量表（SSRS）评定，对患者做简易精神状态检查表（MMSE）、日常生活功能量表（ADL）及神经精神科问卷（NPI）调查，并对各组照料者心理健康状况及其影响因素进行比较分析。结果（1）192例AD照料者SCL‐90总分（133．76±15．58）分及其躯体化、抑郁、恐怖得分明显高于中国常模（t＝3．380，P＜0．05），其中躯体化、饮食睡眠、强迫得分高居前三位。住院组、家庭组及机构组SCL‐90总分及各因子得分（敌对除外）差异均有统计学意义（F＝6．680，P＜0．01），其中住院组SCL‐90总分明显低于家庭组（t＝－3．525，P＜0．05），机构组与其他2组差异无统计学意义（P＞0．05）。（2）AD照料者SCL‐90总分与照料时间、SSRS评分呈正相关（P＜0．05），与照料者年龄、是否家属、躯体疾病、ZBI评分呈明显正相关（P＜0．01）。住院组和家庭组SCL‐90总分均与ZBI总分呈明显正相关（ P＜0．01），与主观支持呈明显负相关（ P＜0．01），机构组SCL‐90总分则与ZBI、SSRS得分相关，差异均无统计学意义（P＞0．05）。（3）ZBI总分、个人负担、照料者躯体疾病、照料者年龄是AD照料者SCL‐90总分得分的主要预测因子。结论 AD照料者存在明显心理健康问题，其主要影响因素是照料负担。
목적：탐구아이자해묵병（AD）환자조료자적심리건강상황급기영향인소。방법대AD조료자진행증상자평량표（SCL‐90）、찰서특조료부담량표（ZBI）、사회지지평정량표（SSRS）평정，대환자주간역정신상태검사표（MMSE）、일상생활공능량표（ADL）급신경정신과문권（NPI）조사，병대각조조료자심리건강상황급기영향인소진행비교분석。결과（1）192례AD조료자SCL‐90총분（133．76±15．58）분급기구체화、억욱、공포득분명현고우중국상모（t＝3．380，P＜0．05），기중구체화、음식수면、강박득분고거전삼위。주원조、가정조급궤구조SCL‐90총분급각인자득분（활대제외）차이균유통계학의의（F＝6．680，P＜0．01），기중주원조SCL‐90총분명현저우가정조（t＝－3．525，P＜0．05），궤구조여기타2조차이무통계학의의（P＞0．05）。（2）AD조료자SCL‐90총분여조료시간、SSRS평분정정상관（P＜0．05），여조료자년령、시부가속、구체질병、ZBI평분정명현정상관（P＜0．01）。주원조화가정조SCL‐90총분균여ZBI총분정명현정상관（ P＜0．01），여주관지지정명현부상관（ P＜0．01），궤구조SCL‐90총분칙여ZBI、SSRS득분상관，차이균무통계학의의（P＞0．05）。（3）ZBI총분、개인부담、조료자구체질병、조료자년령시AD조료자SCL‐90총분득분적주요예측인자。결론 AD조료자존재명현심리건강문제，기주요영향인소시조료부담。
Objective To investigate the mental health status and influencing factors of caregivers of the pa‐tients with Alzheimer′s disease .Methods The Symptom Checklist‐90 (SCL‐90) ,Zarit Caregiver Burden Interview (ZBI) and Social Support Rating Scale(SSRS) were adopted to evaluate the disease caregivers .The Mini Mental State Examination (MMSE) ,Activities of Daily Living (ADL) and NeuroPsychiatric Inventory(NPI) were used to evaluate the patients with Alzheimer′s disease .The mental health status and influencing factors in each caregivers group were conducted the comparative analysis .Results (1) The total score(133 .76 ± 15 .58) of SCL‐90 in 192 dementia care‐givers and the scores of somatization ,depression and terror were significantly higher than Chinese norm (t=3 .380 , P<0 .05) ,in which the scores of somatization ,diet sleep and compulsion got the top three places .The total score of SCL‐90 and each dimension scores(except hostility) had statistically significant differences among the hospitalization group ,family group and the institution group (F=6 .680 ,P<0 .01) ,the SCL‐90 scores in the hospitalization group were significantly lower than those in the family group (t= -3 .525 ,P<0 .05) ,no statistically significant difference existed between the institution group with other two groups (P>0 .05) .(2) The total scores of SCL‐90 in the family caregivers were significantly positively correlated with the care time and SSRS score (P< 0 .05) ,and significantly positively correlated with age ,whether family members ,somatic disease and ZBI score (P<0 .01) .In the hospitaliza‐tion and family groups ,the SCL‐90 total scores were significantly positively correlated with the ZBI total score (P<0 .01) ,and significantly negatively correlated with subjective support (P<0 .01) ,the SCL‐90 total scores in the insti‐tution group were correlated with the ZBI scores and SSRS scores ,the difference had no statistical significance (P>0 .05) .(3) The total score of ZBI ,personal burden ,caregivers age ,somatic disease were the main predictor of SCL‐90 scores in dementia caregivers .Conclusion Alzheimer′s disease caregivers have obvious mental health problems ,the main influencing factors are care burden .