Study On Impact Of Expressed Emotion And Coping Styles On Dementia Caregivers' Psychological Distress

Objective:The first purpose of this study is to understand the situation of expressed emotion,coping styles and psychological distress of caregivers with dementia patients.Then,exploring the correlation between expressed emotion,coping styles and psychological distress and exploring interrelationship between variables by building a structural equation model.This research aimed at improving the mental health of caregivers with dementia patients and improving the quality of care for patients with dementia.Methods:In this study,a convenient sampling method was used to select 156 caregivers of dementia patients who visited the memory clinic of a top three hospital in Changchun City from March to August 2018.The questionnaires included four parts: General Information Questionnaire of Patient and Caregiver,Family Attitude Scale,Simplified Coping Style Questionnaire and 12-item General Health Questionnaire.The data was entryed by Epidata3.1 and the results were statistically analyzed using SPSS 23.0.The structural equation model was established using Amos 23.0.The general demographic characteristics of subjects were described using the frequency and percentage.The K-S test was used to examine the normality of expressed emotion,coping styles and psychological distress scores of caregivers.Using t-test,analysis of variance,nonparametric rank sum test and multiple linear stepwise regression analysis to study factors of psychological distress in caregivers of dementia patients.The correlation analysis was applied by Spearman correlation analysis.Results:1.The high-risk psychological distress group of caregivers accounted for 57.7%,with an average score of(4.74±3.62).The influencing factors include age,severity,self-care status of the patient and the relationship between patient and caregiver,whether lived together,the relationship with the patient before the care,whether employing a babysitter or a care worker and whether there was an idea of sending the patient to a nursing home.2.The median score of expressed emotion was 53(30~107).The average score of positive coping styles was(1.77±0.51)and the average score of negative coping styles was(1.11±0.49)points.3.Expressed emotion had a negative correlation with coping styles(P<0.01),and a positive correlation with psychological distress level(P<0.01).Negative coping styles could increase the psychological distress of caregivers(P<0.05).4.Expressed emotion had a direct negative predictive effect on the positive coping styles of caregivers of dementia patients,and had a direct positive predictive effect on negative coping styles,while positive coping styles and negative coping styles had no mediating effect.Conclusions:1.Caregivers had certain negative attitudes and behavioral manifestations on the patients with dementia,especially those lived with older,more serious patients,had lower levels of education,had no work,lived together with the patient and had a bad relationship with patients before care.2.Although caregivers had taken some coping measures,they still faced great psychological distress and burden.3.The level of expressed emotion of caregivers affected coping styles,which was significantly positive correlated with negative coping styles,and positively predicted psychological distress level;however,coping styles had no significant predictive effect on psychological distress.