Abstract：
OBJECTIVE: This study aimed to investigate the mediating effects of quality of the caregiving relationship and other carer and person with dementia variables in predicting carer resilience over time.
METHODS: Carers of people with mild and moderate dementia in community settings completed baseline (n = 176 dyads) and six-month follow-up assessments (n = 139 dyads). Causal mediation analysis was conducted using Pearson Correlation and Structural Equation Modelling (SEM) to examine longitudinal predictors of carer resilience, and the effect of several mediating person with dementia, and carer factors on carer resilience over time.
RESULTS: At 6-month follow-up, higher levels of carer resilience were longitudinally correlated with higher ratings of perceived relationship quality by people with dementia (r = 0.53 p ≤ 0.01), and lower levels of emotional distress symptoms by carer\'s (r = -0.59 p ≤ 0.01). Mediation analyses showed that people with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms (β = -0.32, p ≤ 0.001) and carer resilience (β = 0.53, p ≤ 0.001) over time. The final SEM provided a good fit for the data (X 2 = 0.12, p = 0.72, CFI = 1.00, NFI = 0.99, and Root Mean Square Error of Approximation = 0.001).
CONCLUSIONS: Higher ratings of perceived relationship quality by people with dementia, and lower levels of carer emotional distress predicted higher carer resilience at follow-up. People with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms and carer resilience over time. Our findings indicate that interventions aimed at strengthening the caregiving relationship might have a protective long-term effect for carer resilience in dementia caregiving.
METHODS: Carers of people with mild and moderate dementia in community settings completed baseline (n = 176 dyads) and six-month follow-up assessments (n = 139 dyads). Causal mediation analysis was conducted using Pearson Correlation and Structural Equation Modelling (SEM) to examine longitudinal predictors of carer resilience, and the effect of several mediating person with dementia, and carer factors on carer resilience over time.
RESULTS: At 6-month follow-up, higher levels of carer resilience were longitudinally correlated with higher ratings of perceived relationship quality by people with dementia (r = 0.53 p ≤ 0.01), and lower levels of emotional distress symptoms by carer\'s (r = -0.59 p ≤ 0.01). Mediation analyses showed that people with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms (β = -0.32, p ≤ 0.001) and carer resilience (β = 0.53, p ≤ 0.001) over time. The final SEM provided a good fit for the data (X 2 = 0.12, p = 0.72, CFI = 1.00, NFI = 0.99, and Root Mean Square Error of Approximation = 0.001).
CONCLUSIONS: Higher ratings of perceived relationship quality by people with dementia, and lower levels of carer emotional distress predicted higher carer resilience at follow-up. People with dementia perspectives of the quality of the caregiving relationship mediated the relationship between carer distress specific to neuropsychiatric symptoms and carer resilience over time. Our findings indicate that interventions aimed at strengthening the caregiving relationship might have a protective long-term effect for carer resilience in dementia caregiving.
摘要：
目的：本研究旨在探讨照顾者关系的质量和其他照顾者和痴呆症患者变量在随时间预测照顾者韧性中的中介作用。
方法：社区环境中轻度和中度痴呆患者的照顾者完成了基线（n=176分）和6个月的随访评估（n=139分）。使用皮尔逊相关性和结构方程模型（SEM）进行因果调解分析，以检查护理者弹性的纵向预测因子，以及几个调解痴呆症患者的作用，以及照顾者因素对照顾者韧性的影响。
结果：在6个月的随访中，较高的照顾者韧性水平与痴呆症患者对感知关系质量的较高评级纵向相关(r=0.53p≤0.01)，护理者的情绪困扰症状水平较低(r=-0.59p≤0.01)。中介分析表明，痴呆症患者对护理关系质量的看法介导了特定于神经精神症状（β=-0.32，p≤0.001）的照顾者困扰与照顾者韧性（β=0.53，p≤0.001）之间的关系。最终的SEM为数据提供了良好的拟合(X2=0.12,p=0.72,CFI=1.00,NFI=0.99,并且近似均方根误差=0.001)。
结论：痴呆症患者对感知关系质量的评分更高，较低的照顾者情绪困扰水平预测随访时照顾者的韧性较高。痴呆症患者对护理关系质量的看法介导了特定于神经精神症状的照顾者困扰与照顾者韧性之间的关系。我们的发现表明，旨在加强护理关系的干预措施可能对痴呆症护理中的护理者韧性具有长期的保护性作用。
方法：社区环境中轻度和中度痴呆患者的照顾者完成了基线（n=176分）和6个月的随访评估（n=139分）。使用皮尔逊相关性和结构方程模型（SEM）进行因果调解分析，以检查护理者弹性的纵向预测因子，以及几个调解痴呆症患者的作用，以及照顾者因素对照顾者韧性的影响。
结果：在6个月的随访中，较高的照顾者韧性水平与痴呆症患者对感知关系质量的较高评级纵向相关(r=0.53p≤0.01)，护理者的情绪困扰症状水平较低(r=-0.59p≤0.01)。中介分析表明，痴呆症患者对护理关系质量的看法介导了特定于神经精神症状（β=-0.32，p≤0.001）的照顾者困扰与照顾者韧性（β=0.53，p≤0.001）之间的关系。最终的SEM为数据提供了良好的拟合(X2=0.12,p=0.72,CFI=1.00,NFI=0.99,并且近似均方根误差=0.001)。
结论：痴呆症患者对感知关系质量的评分更高，较低的照顾者情绪困扰水平预测随访时照顾者的韧性较高。痴呆症患者对护理关系质量的看法介导了特定于神经精神症状的照顾者困扰与照顾者韧性之间的关系。我们的发现表明，旨在加强护理关系的干预措施可能对痴呆症护理中的护理者韧性具有长期的保护性作用。
