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

摘要：

目的 探讨失智患者家庭照顾者衰弱现状及其潜在分型，并分析不同分型的影响因素。 方法 采用便利抽样法，选取2023年6月—10月在上海市8所社区卫生服务中心就诊的失智患者的家庭照顾者作为调查对象。使用一般资料调查表、Tilburg衰弱评估量表、匹兹堡睡眠质量指数量表、抑郁自评量表、Zarit照顾者负担量表、心理弹性量表进行调查。使用潜在剖面分析探索失智患者家庭照顾者衰弱的潜在分型，采用单因素分析和多元Logistic回归分析探究相关影响因素。 结果 共纳入470名失智患者家庭照顾者，其衰弱发生率为46.17%，家庭照顾者衰弱可被分为3个分型：“综合型-低衰弱组”（70.64%）、“心理社会型-中衰弱组”（19.57%）、“躯体型-高衰弱组”（9.79%）。匹兹堡睡眠质量指数量表得分越高、患2种及以上慢性病的家庭照顾者归属于“躯体型-高衰弱组”的概率较大，抑郁自评量表得分越高、未掌握或部分掌握照护知识及技能、照护关系为配偶的家庭照顾者归属于“心理社会型-中衰弱组”的概率较大，心理弹性量表得分越高的家庭照顾者归属于“综合型-低衰弱组”的概率越大（均P<0.05）。 结论 失智患者家庭照顾者衰弱发生率处于较高水平且存在明显异质性，医护人员应关注家庭照顾者衰弱状况，重点关注“心理社会型-中衰弱组”“躯体型-高衰弱组”的家庭照顾者，及时针对其衰弱特征和影响因素开展精准化干预，以预防或延缓衰弱的发生发展。

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