| Summary: | 碩士 === 輔仁大學 === 臨床心理學系碩士班 === 105 === Purpose: The impacts of Dementia is not only on patients but also their family caregivers. For instance, many dementia caregivers had sleep disturbance. According to the 3P model of insomnia, main factors that cause and maintain one’s insomnia and sleep disturbances are sleepless vulnerabilities, stressful events and false coping behaviors. Currently, researches on Dementia caregivers in Taiwan mainly focus on the relationships between the stress of care-taking and health results. Only few of the researches study the predisposing factors (e.g. vulnerability to insomnia). In addition, there has no clear conclusion on the relation between coping and sleep. In our study, we explore the relationship among the insomnia vulnerability, coping, and sleep patterns of Dementia family caregivers, and the role of insomnia vulnerability and coping between the stress and sleep of Dementia family caregiver.
Method: Our study had approved by both Fu Jen Catholic University and Taipei Medical University Joint Institutional Review Board. The 79 participants in this study were referred by the doctors, clinical psychologists and social workers of either Taipei Medical University Shuang-Ho Hospital or community day care centers in northern Taiwan. All the participants completed a set of questionnaire, including demographic data, Revised Memory and Behavior Problems Checklist, Revised Ways of Coping Checklist, Chinese Pittsburgh Sleep Quality Index, Ford Insomnia Response to Stress Test, Multidimensional Fatigue Symptom Inventory-Short Form-Chinese version, Center for Epidemiologic Studies-Depression Scale. Sleep was measured for 3-days intervals using actigraphy and a sleep diary.
Results: Our results showed that the influence of both objective and subjective stress on subjective sleep quality is mediated by the blame of others coping after controlled depression and fatigue. It seems that if caregivers used more blame of others coping, the complaint of sleep latency would decrease. After entered moderator into analysis, there was a significant moderation effect of insomnia vulnerability. The influence of the average reaction rating on both subjective sleep latency and coping is moderated by vulnerability of insomnia. When the Ford Insomnia Response to Stress Test (FIRST) score was high(>34), their average reaction rating could predict more avoidance coping and decreased subjective sleep latency complaint, but avoidance coping couldn’t significant predict subjective sleep latency complaint.
Conclusions: In our study, the reported sleep quality of Dementia female family caregiver participants was higher than the objective sleep measurement. Also, the age of caregivers were significantly correlated with subjective sleep but not objective sleep data. The FIRST average score of the participants was higher than previous studies, and half of them showed tendency toward depression. We found that more blame of others coping might decrease the complaint to sleep quality, and higher interaction of the average reaction rating and FIRST could be used to predict more avoidance coping and less complaint to sleep latency. When further investigated the moderation effect, we found that high and low FIRST presented an opposite direction. However, significance in the moderation effect was only shown under high FIRST conditions. Taken together, this study suggested that vulnerability to insomnia played an important role in caregiving stress, coping, and subjective sleep.
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