Examining the association between neuropsychiatric symptoms among people with dementia and caregiver mental health: are caregiver burden and affiliate stigma mediators?

BMC Geriatrics

Research

Chieh-hsiu Liu¹  Jung-Sheng Chen²  Jian-An Su³  Chih-Cheng Chang⁴  Hsin-Chi Tsai⁵  Yi-Jung Chen⁶  Chung-Ying Lin⁷  Mark D. Griffiths⁸ 

[1]Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

[2]Department of Medical Research, E-Da Hospital, I-Shou University, 82445, Kaohsiung, Taiwan

[3]Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

[4]School of Medicine, Chang Gung University, Taoyuan, Taiwan

[5]Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan

[6]Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan

[7]Department of Health Psychology, Chang Jung Christian University, Tainan, Taiwan

[8]Department of Psychiatry, School of Medicine, Tzu Chi University, Hualien, Taiwan

[9]Department of Psychiatry, Tzu-Chi General Hospital, Hualien, Taiwan

[10]Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

[11]Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

[12]Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

[13]Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

[14]Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

[15]International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK

关键词: Affiliate stigma;    Burden;    Caregiver;    Dementia;    Mediation;   

DOI  :  10.1186/s12877-023-03735-2

 received in 2022-04-26, accepted in 2023-01-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNeuropsychiatric disturbances are common manifestations of dementia disorders and are associated with caregiver burden and affiliate stigma. The present study investigated affiliate stigma and caregiver burden as mediators for the association between neuropsychiatric symptoms of people with dementia (PWD) and caregiver mental health such as depression and anxiety.MethodsA cross-sectional survey study was carried out with 261 dyads of PWD and informal caregivers from the outpatient department of a general hospital in Taiwan. The survey included the Caregiver Burden Inventory (CBI), the Affiliate Stigma Scale (ASS), the Taiwanese Depression Questionnaire (TPQ), and the Beck Anxiety Inventory (BAI). Mediation models were tested using the Hayes’ PROCESS macro (Model 4 for parallel mediation model; Model 6 for sequentially mediation model).ResultsCaregiver burden, affiliate stigma, caregiver depression, and caregiver anxiety were significantly associated with neuropsychiatric symptoms. After controlling for several potentially confounding variables, it was found that PWD’s neuropsychiatric symptoms, caregiver burden and affiliate stigma significantly explained 52.34% of the variance in caregiver depression and 37.72% of the variance in caregiver anxiety. The parallel mediation model indicated a significantly indirect path from PWD’s neuropsychiatric symptoms to caregiver mental health through caregiver burden and affiliate stigma, while the direct effect was not significant. Moreover, there was a directional association between caregiver burden and affiliate stigma in the sequential mediation model.ConclusionsThese findings show that it is imperative to improve caregivers’ perception of those with dementia to reduce internalized stigma and to improve caregivers’ mental health. Implementation of affiliate stigma assessment in clinical practice would allow distinctions to be made between the impact of affiliate stigma and the consequences of caregiver burden to help inform appropriate intervention.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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