明永琴　邓婧　张启文　王丽　罗环跃

[關键词] 阿尔茨海默病;照顾者;痴呆知识;病耻感

[中图分类号] R741;R473.59          [文献标识码] A          [文章编号] 1673-9701（2021）17-0017-04

Current status and influencing factors of dementia knowledge and stigma among middle-aged and elderly caregivers of Alzheimer′s disease

MING Yongqin1   DENG Jing2   ZHANG Qiwen1   WANG Li1   LUO Huanyue3

1.Department of Geriatrics，the Second People′s Hospital of Guizhou Province， Guiyang   550004， China; 2.Department of Psychiatry， the Second People′s Hospital of Guizhou Province， Guiyang   550004， China; 3.Special Needs Clinic，the Second People′s Hospital of Guizhou Province， Guiyang   550004， China

[Abstract] Objective To investigate the awareness of AD，stigma level and its influencing factors among middle-aged and elderly caregivers of Alzheimer′s disease. Methods From March 2019 to January 2020，156 middle-aged and elderly caregivers of Alzheimer′s disease in the memory disorder clinic and geriatric department of Guizhou Provincial Psychiatric Hospital were conducted by trained investigators using the Alzheimer′s Disease Knowledge Scale （ADKS） and Associated Stigma Scale （ASS）. The cross-sectional surveys were conducted through face-to-face interviews. Results The ADKS score and the ASS score of middle-aged and elderly caregivers of Alzheimer′s disease were（18.79±3.10） points and（45.71±10.39） points， respectively. There was a statistically significant difference in ADKS scores of people with different education years， work status， residence， and family per capita monthly income（P<0.05）. There was a statistically significant difference in the ASS scores of people with different age groups， education years， work status， residence， family history of dementia， and family monthly income per capita（P<0.05）. Multiple linear regression analysis showed that education years and work status were the influencing factors of ADKS score， and education years and family history of dementia were the influencing factors of ASS score. The difference was statistically significant（P<0.05）. Conclusion Middle-aged and elderly caregivers of Alzheimer′s disease do not have a high level of awareness of AD and have a strong sense of stigma. It is urgent to increase the publicity of AD knowledge to promote early detection and early treatment of AD patients.

[Key words] Alzheimer′s disease; Caregiver; Dementia knowledge; Stigma

全球老龄化社会的发展，引起了痴呆、失能等一系列社会问题。相关数据显示，2015年全球阿尔茨海默病患者为4680万人，预计2050年将会突破1.315亿人;2015年中国阿尔茨海默病（Alzheimer′s disease，AD）的经济负担为1677.4亿美元，预计2030年将达到2.54万亿美元[1-2]。然而，以AD为代表的痴呆症诊断率在高收入国家约为50%，在低收入和中等收入国家仅为5%～10%[3]，可能与大众对痴呆症的知晓程度及病耻感密切相关。本研究旨在通过问卷调查的方式，调查阿尔茨海默病中老年照顾者AD知晓与病耻感现状及其影响因素，为AD的早发现、早治疗，进一步降低AD带来的疾病负担提供干预依据，现报道如下。

1 资料与方法

1.1 一般资料

采用方便抽样方法，于2019年3月至2020年1月在贵州省级精神专科医院记忆障碍门诊及老年科住院患者被诊断为AD的患者家属中，选择符合入组标准的阿尔茨海默病中老年照顾者发放问卷调查。患者均符合2011美国国立老化研究所与阿尔茨海默病协会（National institute on aging-Alzheimer′s disease Association）AD的诊断标准[4]。照顾者纳入标准：①照顾者为AD患者的配偶、子女或兄弟姐妹等与其有亲属关系且主要负担照顾的家庭成员;②年龄45～75岁者;③知情同意并配合者;④意识清楚、言语正常者。排除标准：①有语言表达及交流障碍者;②既往有精神病史者;③不予配合或中途退出者。

1.2 方法

1.2.1 调查工具  ①研究对象的一般资料：包括照顾者的年龄、性别、婚姻状况等基本信息。……