老年痴呆患者家庭照顾者创伤后成长现状及影响因素的混合研究

doi:10.3761/j.issn.0254-1769.2025.17.007

摘要/Abstract

摘要：

目的探索老年痴呆患者家庭照顾者创伤后成长现状并分析影响因素，为制订创伤后成长干预措施提供参考。方法采用聚敛式混合研究设计，便利选取2024年5—12月上海市某三级医院和某精神卫生中心门诊就诊的269名老年痴呆患者家庭照顾者为调查对象，使用一般资料调查问卷、简体中文版创伤后成长问卷、简易应对方式问卷、简体中文版事件相关反刍性沉思问卷、简化版心理弹性量表和社会支持评定量表进行调查，采用多元逐步线性回归对数据进行分析；采用目的性抽样对19名老年痴呆患者家庭照顾者进行半结构式访谈，使用定向内容分析法对访谈资料进行分析。结果老年痴呆患者家庭照顾者创伤后成长得分为（64.73±11.43）分，回归结果显示，患者痴呆类型、患者合并慢性病种类、对疾病知识了解程度、目的性反刍性沉思、积极应对方式、心理弹性和社会支持是其创伤后成长的影响因素（P<0.05）。质性研究依据个体自身因素、家庭社会因素和文化环境因素3个方面提炼了8个主题。整合结果显示量性与质性研究结果相互验证与补充。结论老年痴呆患者家庭照顾者创伤后成长处于中低水平，其影响因素包括患者因素、照顾者自身因素和社会文化因素3个方面，提示医护人员应关注家庭照顾者创伤后成长，针对其影响因素制订个性化干预措施，以提高其创伤后成长水平。

关键词: 老年人, 痴呆, 家庭照顾者, 创伤后成长, 混合研究, 护理

Abstract:

Objective To describe the current status of post-traumatic growth among family caregivers of dementia and analyze its influencing factors to provide a reference for the development of post-traumatic growth interventions. Methods A convergent mixed-methods study was adopted. Family caregivers of older adults with dementia who were outpatients at a tertiary hospital and a mental health center in Shanghai from May to December 2024 were conveniently selected for the study. A general information questionnaire，the Chinese-Posttraumatic Growth Inventory，the Simplified Coping Style Questionnaire，the Simplified Chinese Event Related Rumination Inventory，the Connor-Davidson Resilience Scale，and the Social Support Rating Scale were used for data collection. The survey was conducted，and the data were analyzed using multivariate stepwise linear regression. 19 family caregivers of dementia patients were interviewed in a semi-structured manner using purposive sampling，and the interview data were analyzed using directed content analysis. Results The dementia family caregivers’ post-traumatic growth score was（64.73 ± 11.43）. The regression results showed that patients’ dementia type，types of comorbid chronic diseases，knowledge of the disease，deliberate rumination，positive coping styles，psychological resilience，and social support were the influencing factors of post-traumatic growth（P<0.05）. Qualitative results：interviews refined 8 themes based on 3 dimensions，including individual factors，family and social factors，and cultural and environmental factors. The integration results indicate that both quantitative and qualitative findings were validated and complemented. Conclusion Dementia family caregivers’ post-traumatic growth is low to moderate，and the influencing factors are associated with 3 aspects，namely patient factors，caregiver factors，and socio-cultural factors. Healthcare professionals should pay attention to caregivers’ post-traumatic growth and develop personalized interventions based on influencing factors，enhancing their level of post-traumatic growth.

Key words: Aged, Dementia, Family Caregivers, Post-Traumatic Growth, Mixed Methods Study, Nursing Care

王洋, 顾艳荭, 龙德超, 王君俏. 老年痴呆患者家庭照顾者创伤后成长现状及影响因素的混合研究[J]. 中华护理杂志, 2025, 60(17): 2087-2094.

WANG Yang, GU Yanhong, LONG Dechao, WANG Junqiao. A mixed-methods study on the current status of post-traumatic growth and influencing factors among family caregivers of older adults with dementia[J]. Chinese Journal of Nursing, 2025, 60(17): 2087-2094.

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