A Mixed Study Of Care Burden Of Family Caregivers Of Old People With Dementia Supported By Long-term Care Insurance

Research background and purpose:To investigate current situation and factors affecting care burden of family caregivers of old people with dementia supported by long-term care insurance(LTCI);to describe care experiences and care needs of family caregivers of old people with dementia supported by LTCI,then making recommendations.Materials and Methods:The study adopted a consistent parallel design in a mixed-methods study.Family caregivers of old people with dementia with the support of LTCI in Chengdu were selected as participants.1.Quantitative study used convenience sampling to select 1146 participants and collected data using the Caregiver Burden Inventory(CBI),the Social Support Rating Scale(SSRS),and the general information questionnaire for old people with dementia and family caregivers.Descriptive statistical analysis,independent samples t-test,one-way analysis of variance,multiple linear regression and Pearson correlation test were conducted using SPSS 26.0 software.2.Qualitative study used a descriptive phenomenological research method to select52 participants to take part in semi-structured interviews through purposive sampling,and a 1-week participatory observation of home care services,applying the Colaizzi’s analysis method to refine themes.Result:1.Quantitative study results:(1)CBI score of family caregivers of old people with dementia supported by LTCI was 32.92±14.29;the five dimensions were Time-dependence burden,Developmental burden,Physical burden,Emotional burden,and Social burden in descending order of score.(2)Multiple linear regression results showed that the differences in CBI were statistically significant(P<0.05)in terms of family caregivers whether full-time care,with or without the assistance of others for care,as well as the gender of old people with dementia,type of insurance coverage,number of types of other chronic diseases and years of dementia.(3)SSRS for family caregivers of old people with dementia supported by LTCI was 37.66±7.68,which was at a moderate to low level.CBI of family caregivers was negatively correlated with SSRS(r =-0.186,P<0.01).2.Qualitative study results:(1)Three themes emerged from caring experiences of family caregivers of old people with dementia supported by LTCI: caring was overwhelming(inadequate conditions,multiple role conflicts,lack of caring capacity),family support was inadequate(distant family relationships,peer pressure),and LTCI was a blessing(subsidies were practical,home care services were heart-warming).(2)Four themes emerged from care needs of family caregivers of old people with dementia supported by LTCI: the need to alleviate financial burden,the need to strengthen home care services(increased hosting services,medical and professional care,improved staffing profession),the need to improve care skills(knowledge of illnesses,knowledge of daily care),and the need for psychological comfort.Conclusion:1.The care burden of family caregivers of old people with dementia supported by LTCI is at medium level.The main factors influencing care burden include the social support of family caregivers,whether full-time care,with or without the assistance of others for care,and the gender,type of insurance coverage,number of types of chronic diseases and years of dementia suffered by the old people with dementia.2.The care burden is negatively correlated with social support,therefore,social support for family caregivers should be increased to reduce care burden and improve their quality of life.3.The existing LTCI is limited in its support.Financial support is inadequate.And there is also a lack of services for old people with dementia and a lack of training content for dementia care.It is recommended to improve the dementia home care support system based on care institutions and home care services.