失智症病患照顧者負荷之相關因素：一記憶門診研究

The Factors Associated with Burden of Caring Patients with Dementia: A Memory Clinic Based Study

目的：本研究之目的在探究中部某醫學中心記憶門診就診之病人及主要照顧者之特質與 分析照顧者負荷的相關因素。方法：本研究收集及分析西元2007 年1 月至12 月至中部某 醫學中心記憶門診就診之八十八對失智症病人及其主要照顧者之基本資料、失智病人之認知 功能、臨床失智嚴重度、行為精神症狀、照顧者之基本資料、照顧者之負荷程度及照顧者之 憂鬱嚴重程度。結果：線性複迴歸分析顯示簡短式智能評估分數 (t = -2.613, p < 0.05)、臨 床失智量表分數 (t = -2.591, p < 0.05)、及神經精神病徵調查表總分 (t = 17.636, p < 0.001) 與照顧者負荷有統計學上顯著的相關。此預測模式調整後之解釋變異量達到81.3% (F = 55.068, p < 0.001)。42% 的照顧者有憂鬱的問題。結論：簡短式智能評估分數、臨床失智程 度、及病人行為精神症狀為失智症照顧者負荷之相關因素，其中失智症之行為精神症狀之相 關性最強。

Objectives: The purposes of this study were to investigate the demographic data of the patients with dementia and their caregivers in the memory clinic of a medical center in central Taiwan, and to fi nd factors associated with caregivers’ burden in caring patients with dementia. Methods: In the study, we used 88 pairs of patients with dementia and their caregivers who visited the memory clinic from January 1, 2007 to December 31, 2007. We collected the demographic information of patients, patients’ cognitive function, patients’ clinical dementia ratings, and behavioral and psychological symptoms of dementia (BPSD) as well as caregivers’ demographic data, burden, and depressive conditions. We analyzed those data for the relationship between each parameter and caregivers’ burden. Results: The results showed that the scores of Mini-mental State Examination (MMSE) (t = -2.613, p < 0.05), Clinical Dementia Rating scale (CDR) (t = -2.591, p < 0.05), and Neuropsychiatry Inventory (NPI) total score (t = 17.636, p < 0.001) were signifi - cantly associated with Neuropsychiatric Inventory Caregiver Distress Scale (NPID) using the multiple linear regression analyses. The regression model explained 81.3% (F = 55.068, p < 0.001) of the variance in caregivers’ burden. Forty-two percents of the caregivers had the depressive problems. Conclusion: MMSE, CDR, and BPSD of patients with dementia were signifi cant associated factors of caregivers’ burden. Severity of BPSD was most signifi cantly correlated with caregivers’ burden.