Clinical Interventions in Aging (Apr 2020)
Predictors of Perceived Social Support for Patients with Dementia: A Mixed-Methods Study
Abstract
Siyuan Yang,1 Yunmei Zhang,2 Shiqi Xie,2 Yanhan Chen,2 Dengbi Jiang,3 Yetao Luo,4 Qinghua Zhao,1 Bing Yang2 1Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Yuzhong District, People’s Republic of China; 2School of Nursing, Chongqing Medical University, Chongqing, Yuzhong District, People’s Republic of China; 3Community Health Center of Daxigou, Chongqing, Yuzhong District, People’s Republic of China; 4Department of Biostatistics, School of Public Health and Management, Chongqing Medical University, Chongqing, Yuzhong District, People’s Republic of ChinaCorrespondence: Bing Yang; Qinghua Zhao Email [email protected]; [email protected]: Perceived social support (PSS) is closely linked to health outcomes in dementia patients. However, its continuous benefits are unclear. This mixed-methods study examined the impact of social support perceptions and differentiation among patients and carers during disease progression.Patients and Methods: Persons with dementia (PWDs), family caregivers, and community family physicians were recruited from nine community health centers. Semi-structured interviews conducted with 12 PWDs (7 PWDs in mild dementia and 5 in moderate dementia), 12 family caregivers, and 6 community family physicians and conventional content analysis were used to explore social support perspectives at different dementia stages. A total of 470 PWDs were divided into mild (n=224), moderate (n=190), and severe (n=56) groups. Demographic, physical, and psychological factors related to PSS were examined by the group using multiple regression analysis. The group-based characteristics were entered into three prediction models.Results: In the qualitative study, three themes of social support were identified: two viewpoints refer to social support; different needs and preferences in each stage; non-personalized support services. Quantitatively, the mild group scored lowest in perceived social support, while the severe group scored highest (χ2=64.70, P< 0.001). The mild group PSS was predicted by depression (β=− 0.07, P=0.04), cognitive capacity (β=− 0.18, P< 0.001), and instrumental ability (β=− 0.78, P< 0.001), which differed from the moderate and severe groups.Conclusion: This study provided comprehensive insight into PSS from PWDs’ perspective at different stages of the disease. Results indicated the need for a stratified care approach and direction for further research on intervention.Keywords: dementia, illness stages, perceived social support, psychosocial status