关键词: 失智症, 家庭照顾者, 衰弱, 潜在剖面分析, 护理, 问卷调查

Abstract:

Objective To explore the current status and potential subtypes of frailty among family caregivers of patients with dementia，and to analyze the related influencing factors of different subtypes. Methods Dementia patients and their family caregivers in 8 community health service centers in Shanghai from June to October 2023 were recruited by convenience sampling. General information questionnaire，Tilburg Frailty Indicator（TFI），Pittsburgh Sleep Quality Index（PSQI），Self-Rating Depression Scale（SDS），Zarit Caregiver Burden Interview（ZBI），and Connor‐Davidson Resilience Scale（CD-RISC） were conducted for investigation. Latent profile analysis was used to explore the potential subtypes of frailty among family caregivers of patients with dementia. The influencing factors associated with the potential subtypes were identified by univariate analysis and multivariate Logistic regression analysis. Results A total of 470 family caregivers of patients with dementia were surveyed，and 46.17% of them suffered from frailty. Frailty among family caregivers of patients with dementia can be classified into 3 potential subtypes：comprehensive-low frailty subtype（70.64%），psychosocial-medium frailty subtype（19.57%），and physical-high frailty subtype（9.79%）. Family caregivers of patients with dementia who had poor sleep quality and suffered from 2 or more chronic diseases were more likely to be classified into the physical-high frailty subtype（P<0.05）. Family caregivers of patients with dementia who had higher levels of depression，lower mastery levels of caregiving knowledge and skills and spousal caregivers were more likely to be classified into the psychosocial-medium frailty subtype（P<0.05）. Family caregivers of patients with dementia who had higher levels of resilience were more likely to be classified into the comprehensive-low frailty subtype（P<0.05）. Conclusion The incidence of frailty among family caregivers of patients with dementia is at a high level with significant heterogeneity. It is suggested that medical staff should pay attention to the frailty of family caregivers，with a focus on family caregivers in the psychosocial-medium frailty subtype or physical-high frailty subtype，and take timely and targeted interventions according to the characteristics and influencing factors of different subtypes，so as to prevent or delay the occurrence and development of frailty.

Key words: Dementia, Family Caregiver, Frailty, Latent Profile Analysis, Nursing Care, Questionaire