Caap-Ahlgren Marianne, Dehlin Ove
Department of Community Medicine, Malmö University Hospital, Malmö, Sweden.
Aging Clin Exp Res. 2002 Oct;14(5):371-7. doi: 10.1007/BF03324464.
Caregivers of Parkinson's disease patients are vulnerable to detrimental factors related to caregiving because of the progressive course of the disease. Studies of caregivers of these patients are scarce. The aim of this study was to examine the caregiver burden in Parkinson's disease by analyzing caregiver and patient-related factors.
Every 3rd patient with Parkinson's disease registered at the outpatient clinic of the Neurology Department was invited to participate. One year after the first investigation, a follow-up was performed with a study of caregiver burden. A total of 65 caregivers took part. In-home interviews with patients and caregivers were performed.
a) caregiver burden, 22 items, comprising five indices: general strain, isolation, disappointment, emotional involvement, and environment; b) sense of coherence, 13 items, with the components comprehensibility, manageability and meaningfulness; c) depressive symptoms, using the Geriatric Depression Scale, 15 items; d) social contacts, 6 items; e) patient subjective health, assessed with the Parkinson's disease questionnaire, 39 items; and f) patient functional status.
Bivariate analyses showed significant correlations between caregiver burden and sense of coherence in caregivers, patient functional status, depressive symptoms in caregiver and patient, patient subjective health and time since diagnosis. Multivariate analysis showed depressive symptoms and sense of coherence in caregiver, and functional status in patient to be the most important variables for caregiver burden.
To ease the caregiver burden, attention should be paid to patient functional status and caregivers depressive symptoms. The sense of coherence in caregivers is probably more difficult to influence.
由于帕金森病病程呈进行性发展,其患者的照料者易受到与照料相关的不利因素影响。针对这些患者照料者的研究较为匮乏。本研究旨在通过分析照料者及患者相关因素来探究帕金森病患者照料者的负担情况。
邀请神经内科门诊登记在册的每第三位帕金森病患者参与研究。首次调查一年后,对照料者负担进行随访研究。共有65名照料者参与。对患者及照料者进行了入户访谈。
a) 照料者负担,共22项,包括五个指标:总体压力、孤立感、失望感、情感投入和环境;b) 连贯感,共13项,包括可理解性、可管理性和意义性三个维度;c) 抑郁症状,采用老年抑郁量表,共15项;d) 社交联系,共6项;e) 患者主观健康状况,采用帕金森病问卷进行评估,共39项;f) 患者功能状态。
双变量分析显示,照料者负担与照料者的连贯感、患者功能状态、照料者及患者的抑郁症状、患者主观健康状况以及确诊后的时间之间存在显著相关性。多变量分析表明,照料者的抑郁症状和连贯感以及患者的功能状态是影响照料者负担的最重要变量。
为减轻照料者负担,应关注患者功能状态及照料者的抑郁症状。照料者的连贯感可能更难受到影响。