A Study On The Care-giving Competence And Its Influential Factors Of Caregivers For Patients With Senile Dementia Based On The ABC-X Model

Objective: To describe the present situation of care-giving competence in caregivers of dementia patients and discuss its influential factors by a regional cross-sectional survey in Guiyang city,aiming to promote the care-giving competence in family caregivers of dementia patients and improve the quality of life of dementia patients,providing related reference for intervention measures.Methods: A cross-sectional survey and in-depth interviews were conducted.The investigation was carried out from January 2017 to November 2017.A total of 122 family caregivers of hospitalized dementia patients or outpatients in neurology department,rehabilitation department and geriatric ward of 6 hospitals in Guizhou province were surveyed by using general situation questionnaire,Family Care-giving Competence Scale for the Elderly,Marwit-Meuser Caregivers Sadness Scale and Simplified Coping Style Questionnaire.8 caregivers were participated in semi-structured interview.Research datas were recorded by Excel 2007 and statistic analysis was performed with SPSS18.0.The themes of qualitative research were extracted from Colazizi's phenomenological analysis.Results: 1.The total scores of care-giving competence averaged(25.40±4.11),scores of each domains were respectively(10.81±2.27)for family care-giving cognitive competence,(7.00±1.51)for family cohesion and(7.59±1.25)for family support capability.The total scores of sadness averaged(64.10±8.71).The scores of coping style for positive issues concern averaged(1.20±0.62),positive emotional attention averaged(1.37±0.71),passive issues concern averaged(0.93±0.87),passive emotional concern averaged(1.31±0.58),and psychological counseling averaged(1.18±0.70).The scores of quality of life of dementia patients averaged(22.78±2.32).2.The care-giving competence scores of caregivers on different ages,degree of education,health status,recognition of the disease and severity of the disease of patients have significant difference(P<0.05).The care-giving competence scores on patients' gender,age,disease types,chronic disease condition,self-care and medical payment have no significant difference(P>0.05).The care-giving competence scores on caregivers' gender,occupation,relationship with patients,live with patients,care-giving time,financial condition,economic pressures and care-giving reason have no significant difference(P>0.05).3.The results of correlation analysis as follow:scores of sadness were negatively correlated with the scores of care-giving competence(r=-0.190,P < 0.01),while the scores of positive issues concern,positive emotional attention and psychological counseling were positively correlated with the scores of care-giving competence(P <0.01),the passive issues concern were negatively correlated with the scores of care-giving competence,family cohesion and cognitive competence of family care(r=-0.179,-0.196,-0.261,P<0.05),and have no correlation with family supporting capability(P>0.05),the passive emotional concern were negatively correlated with the scores of care-giving competence,family cohesion and cognitive competence of family care(r=-0.245,-0.223,-0.269,P<0.05),and have no correlation with family supporting capability(P>0.05).The scores of care-giving competence were positively correlated with the scores of quality of life of demantia patients(r=0.486,P<0.01).4.Multiple linear regression showed that the caregivers' degree of education,physical condition,recognition of the disease,positive issues concern,positive emotional attention,anxious and sense of isolation have entered into the regression equation,and the major influential factor is the positive issues concern of caregivers.5.Three themes were extracted from the qualitative data included tireness and confusion,psychological adjustment and self-efficiency exploration.Conclusion: 1.Dementia family caregivers have a lower care-giving competence level as a whole in the study,the care-giving competence from high to low were respectively family care-giving cognitive competence,family support capability and family cohesion competence.2.The influential factors of care-giving competence of dementia patients were caregivers' degree of education,physical condition,recognition of the disease,positive issues concern,positive emotional attention,anxious and sense of isolation.3.The care-giving competence self-assessment of caregivers in line with reality,and the care-giving competence of caregivers needs further improvement.