Haley W E, LaMonde L A, Han B, Narramore S, Schonwetter R
Department of Gerontology, University of South Florida, H. Lee Moffitt Cancer Center and Research Institute, Tampa 33620, USA.
Hosp J. 2001;15(4):1-18. doi: 10.1080/0742-969x.2000.11882959.
Caregiving stress has been found to lead to depression and poor health among caregivers compared with age-matched non-caregiving controls. However, most of these studies have focused on dementia caregivers, and have not included hospice caregivers. The aim of this project was to assess the impact of caregiving stress on psychological and health functioning among spousal caregivers of hospice patients, in contrast to demographically matched non-caregiving controls. A secondary aim was to compare the caregiving stressors and psychological and health functioning between spousal caregivers of hospice patients with dementia versus lung cancer.
Forty spousal caregivers of hospice patients with dementia, and 40 spousal caregivers of hospice patients with lung cancer, were compared on admission to hospice, using measures of caregiving stressors, depression, life satisfaction, and physical health, with a sample of 40 demographically equated control subjects.
Both groups of caregivers showed higher depression, lower life satisfaction and poorer physical health (p < .05) compared with non-caregivers. Over half of all caregivers evidenced clinically significant levels of depression, with rates of depression about three times the prevalence found in community samples of older adults.
While family caregivers of hospice patients with dementia and lung cancer face very different objective stressors, the negative psychological and health impacts on the caregiver are marked and comparable across diagnosis. Hospice family caregivers are at high risk for both psychological and physical health disorders, and caregiver depression and health problems should be systematically assessed and treated by the hospice team.
与年龄匹配的非照料对照组相比，照料压力已被发现会导致照料者出现抑郁和健康状况不佳的情况。然而，这些研究大多集中在痴呆症照料者身上，并未将临终关怀照料者纳入其中。本项目的目的是评估照料压力对临终关怀患者配偶照料者心理和健康功能的影响，并与人口统计学特征匹配的非照料对照组进行对比。第二个目的是比较痴呆症临终关怀患者配偶照料者与肺癌临终关怀患者配偶照料者之间的照料压力源以及心理和健康功能。
在临终关怀入院时，对40名痴呆症临终关怀患者的配偶照料者、40名肺癌临终关怀患者的配偶照料者，使用照料压力源、抑郁、生活满意度和身体健康等测量指标进行比较，并选取40名人口统计学特征相当的对照对象作为样本。
与非照料者相比，两组照料者均表现出更高的抑郁水平、更低的生活满意度和更差的身体健康状况（p < 0.05）。超过半数的照料者表现出临床上显著的抑郁水平，其抑郁发生率约为老年社区样本中患病率的三倍。
虽然痴呆症临终关怀患者和肺癌临终关怀患者的家庭照料者面临截然不同的客观压力源，但对照料者的负面心理和健康影响显著且在不同诊断之间具有可比性。临终关怀家庭照料者面临心理和身体健康障碍的高风险，临终关怀团队应系统地评估和治疗照料者的抑郁及健康问题。
