Perceived Stress And Its Influencing Factors Among Primary Caregivers Of Dementia Patients

ObjectiveTo investigate perceived stress of primary caregivers of dementia patients.To analyze the influencing factors of perceived stress of primary caregivers.According to the influencing factors of perceived stress of primary caregivers,the nurse should carry out personalized intervention measures to reduce the level of perceived stress,in order to provide theoretical basis for improving the mental health of primary caregivers.MethodsThis study is a cross-sectional study,using convenience sampling method from November 2019 to November 2020,171 primary caregivers of dementia patients in the inpatient department and outpatient department of a tertiary hospital in Da lian were selected as the research objects.The general information questionnaire,Experiences in close relationships questionnaire(ECR),Connor-Davidson Resilience Scale(CD-RISC)and Perceived Stress Scale(PSS)were used to investigate.The data were input by two persons in Excel and analyzed by SPSS 24.0 software.The analysis methods included descriptive analysis,t tests,univariate analysis of variance,Pearson correlation analysis and multiple linear regression analysis.Amos24.0 software was used to construct the structural equation model,and bootstrap method was used to test.The test level was α =0.05.Results1.The total score of perceived stress of primary caregivers of dementia patients was(31.19 ± 6.91);the dimension of tension was(16.31 ± 4.16),which was higher than the dimension of out of control(14.88 ± 3.39);only 32.20% of the primary caregivers were in the normal range of perceived stress,and 77.80% of the primary caregivers were in the state of health risk stress.The score of attachment anxiety of primary caregivers was(68.60 ± 10.33)and the score of attachment avoidance was(54.81 ±7.44);safe attachment、focused attachment、apathetic attachment and phobic attachment was 26.90% 、 42.10% 、 12.30% and 18.70% respectively;89.50% of the primary caregivers attached to their spouses,while only 10.50% attached to their children.The total score of resilience of main caregivers was(58.06 ± 9.11),and the average score of each dimension from high to low was: tenacity(2.46 ± 0.40),self-improvement(2.17 ±0.45)and optimism(2.16 ± 0.40).2.The results of multiple linear regression analysis showed that the severity of dementia,the care time of the primary caregivers,the number of caregivers shared,the self-conscious health status,the "taking care of patients is very important to themselves",attachment anxiety,attachment avoidance,and psychological resilience entered the regression equation,which together explained the variation of 55.20% of the primary caregivers’ perceived stress level.3.The results of structural equation model and bootstrap test showed that the 95%confidence intervals of total effect,direct effect and indirect effect of attachment anxiety and attachment avoidance on perceived stress in adult attachment did not include 0,and the difference was statistically significant.The mediating effects of resilience on attachment anxiety,attachment avoidance and perceived stress were 35.22% and32.75% of the total effects.Conclusion1.The main caregivers’ perceived stress level was higher than the domestic norm,and the difference was statistically significant,in which the sense of tension was stronger than the sense of out of control.In adult attachment,the attachment anxiety was at a higher level and the attachment avoidance was at a lower level;the main caregivers with unsafe attachment were more than those with safe attachment;In addition,most of the primary caregivers’ attachment objects were spouses.The primary caregivers’ resilience level is generally low and lower than the domestic norm,the difference is statistically significant.2.The perceived stress of primary caregivers is affected by the severity of dementia,the time of primary caregivers’ care,the number of caregivers shared,the self-conscious health status,the cognition of "taking care of patients is very important to themselves",attachment anxiety,attachment avoidance and resilience.Nurses should understand the influencing factors of perceived stress,and then according to the influencing factors take personalized intervention measures to reduce their perceived stress level.3.Attachment anxiety and attachment avoidance in adult attachment of primary caregivers can not only directly predict their perceived stress,but also indirectly predict their perceived stress through the resilience of mediating effect,which indicates that nurses can further improve the psychological resilience level of primary caregivers by taking care needs as the benchmark,providing various care support,strengthening their ability to deal with and solve problems,etc,so as to indirectly reduce the negative impact of unsafe attachment on their perceived stress.