Current status and associated factors of training demand among caregivers of dementia patients at home
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摘要: 目的 了解中国痴呆家属照料者对照料培训的需求现状及其可能的影响因素。方法 样本取自于2012年11月-2013年3月全国阿尔茨海默病临床就诊路径多中心登记研究的基线调查,共有752名痴呆照料者完成了照料培训需求问卷调查。结果 在752名照料者中,49人(6.52%)曾经接受过痴呆照料培训,450人(59.84%)表示需要接受痴呆照料培训;照料者对照料培训的内容需求前3位的分别为日常照护(86.3%)、基础知识(80.3%)以及应对问题行为(79.7%),最期望通过电视/广播(85.0%)、社区健康讲座(80.9%)以及报纸/杂志(76.4%)等形式获得照料培训;比较需要培训组与不需要培训组的痴呆患者,其职业类型、家庭人均年收入、糖尿病、高血压、高血脂、脑卒中等病史、痴呆临床类型差异有统计学意义(P<0.05);多因素非条件logistic回归分析显示,患者为农民(OR=0.201,95%CI=0.086~0.468)、教师/科研/医务人员(OR=0.431,95%CI=0.214~0.867)、公务员(OR=0.303,95%CI=0.104~0.879)与干部管理人员(OR=0.497,95%CI=0.253~0.977)时,其照料者对照料培训需求更高(P<0.05),家庭人均年收入为12000~30000元(OR=1.675,95%CI=1.155~2.428)或<12000元(OR=2.265,95%CI=1.374~3.733)、血管性痴呆患者(OR=2.051,95%CI=1.161~3.623)的照料者照料培训需求更低(P<0.05)。结论 痴呆照料者对居家照料培训需求较大,其需求与患者的社会经济地位以及疾病特征有一定关系。Abstract: Objective To assess the demand for training among caregivers of dementia patients at home,and to explore factors associated with the demand.Methods The data on training demand of 752 home care givers of dementia patients were derived from the baseline survey of the National Multi-Center Observational Registry Study for Alzheimer Disease conducted at 28 tertiary hospitals in 16 cities between November 2012 through March 2013 in China.Results Of all the caregivers,only 49(6.52%)reported ever receiving training for dementia care and 450(59.84%)reported the demand for the training,with the top three required trainings for daily routine care(86.3%),essential related knowledge(80.3%),and management of problem behaviors(79.7%);the required major training routes included television/radio program(85.0%),health education lecture in the community(80.9%),and newspaper/magazine(76.4%).There were significant differences in the dementia patients' occupation,annual household income,disease comorbidity(diabetes,hypertension,hyperlipidemia,and stroke),and the subtypes of dementia between their caregivers with and without training demand(all P<0.005).The results of multivariate unconditional logistic regression showed that higher training demand of the caregivers was associated with dementia patient's occupation(teacher/technical or medical professional:odds ratio[OR]=0.431,95% confidence interval[95%CI]=0.214-0.867;cadre or administrative staff:OR=0.497,95%CI=0.253-0.977;civil servant:OR=0.303,95%CI=0.104-0.879;and farmer:OR=0.201,95%CI=0.086-0.468);whereas lower training demand of the caregivers was associated with dementia patient's annual household income(30 000-12 000[RMB yuan]:OR=1.675,95%CI=1.155-2.428;<12 000:OR=2.265,95%CI=1.374-3.733)and type of dementia(vascular dementia:OR=2.051,95%CI=1.161-3.623).Conclusion The caregivers of dementia patients at home have higher training demand and the demand is influenced by socioeconomic status and disease condition of the patients under their cares.
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