Alvarez-Ude Fernando, Valdés Covadonga, Estébanez Carmen, Rebollo Pablo
Nephrology Unit of the General Hospital of Segovia and Institute Reina Sofia for Nephrological Research of the FRIAT, Segovia, Spain.
J Nephrol. 2004 Nov-Dec;17(6):841-50.
This study aimed to evaluate the health-related quality of life (HRQOL) and burden on family caregivers of chronic dialysis patients and to analyze which factors were associated with it.
A cross-sectional multicentric study was carried out with 221 patient/caregiver pairs. General population Short Form 36 (SF-36) norms were used to estimate gender and age standardized physical component summary (PCS) and mental component summary (MCS) scores. The Duke-UNC Functional Social Support Questionnaire (FSS), the Zarit Burden Interview (ZBI), and sociodemographic and clinical data were also collected.
The PCS and MCS of caregivers were slightly worse than that of the Spanish population. Multiple regression analysis showed that: (1) lower PCS was associated with younger age and higher ZBI of the caregiver (R2=0.15); (2) lower MCS was associated with higher ZBI and lower FSS of the caregiver, and lower MCS of the patient (R2=0.29); (3) higher ZBI was associated with lower FSS, PCS and MCS of the caregiver, and to older age and lower PCS and MCS of the patient (R2=0.49). Of caregivers 28.3% had a MCS < or = 42; logistic regression analysis showed that a MCS < or = 42 was associated to higher ZBI and lower FSS scores (p<0.001).
The HRQOL of dialysis patient family caregivers is slightly worse than that of the Spanish population of the same age and gender. Younger family members, who are the primary carers of older dialysis patients with poor HRQOL, experienced a higher burden, had a worse HRQOL and had a higher risk of clinical depression; this was worse if low social support was perceived.
本研究旨在评估慢性透析患者的健康相关生活质量(HRQOL)及其家庭照顾者的负担,并分析与之相关的因素。
对221对患者/照顾者进行了一项横断面多中心研究。使用一般人群简明健康调查问卷(SF-36)规范来估计性别和年龄标准化的身体成分总结(PCS)和心理成分总结(MCS)得分。还收集了杜克大学-北卡罗来纳大学功能性社会支持问卷(FSS)、扎里特负担访谈(ZBI)以及社会人口统计学和临床数据。
照顾者的PCS和MCS略低于西班牙人群。多元回归分析表明:(1)较低的PCS与照顾者年龄较小和较高的ZBI相关(R2 = 0.15);(2)较低的MCS与照顾者较高的ZBI和较低的FSS以及患者较低的MCS相关(R2 = 0.29);(3)较高的ZBI与照顾者较低的FSS、PCS和MCS以及患者年龄较大和较低的PCS和MCS相关(R2 = 0.49)。28.3%的照顾者MCS≤42;逻辑回归分析表明,MCS≤42与较高的ZBI和较低的FSS得分相关(p<0.001)。
透析患者家庭照顾者的HRQOL略低于同年龄和性别的西班牙人群。年轻的家庭成员作为HRQOL较差的老年透析患者的主要照顾者,负担较重,HRQOL较差,临床抑郁风险较高;如果感觉到社会支持较低,情况会更糟。