Choi-Kwon Smi, Kim Hwa-Sung, Kwon Sun U, Kim Jong S
College of Nursing, Seoul National University, Seoul, Korea.
Arch Phys Med Rehabil. 2005 May;86(5):1043-8. doi: 10.1016/j.apmr.2004.09.013.
To elucidate the factors related to the caregiver burden in stroke survivors in Seoul, Korea.
Cross-sectional study.
Outpatient clinic of a university hospital in Korea.
We randomly selected 340 stroke patients and evaluated them for 3 years poststroke. Among them, 147 caregivers and patients were finally interviewed.
Patients' demographic data, neurologic symptoms, depression, emotional incontinence, and Modified Rankin Scale (MRS) score were assessed. In addition, primary caregivers' demographic data, hours of care per day, relationship with the patients, health status, anxiety and depression, and the presence of alternative caregivers were assessed.
Caregiver burden was evaluated with the Sense of Competence Questionnaire, which has 3 subdomains with a total of 27 items.
Caregiver burden score was high as compared with reports from Western society. Patient factors related to the burden scores were being unemployed ( P <.05), the presence of diabetes mellitus ( P <.05), aphasia ( P <.01), dysarthria ( P <.05), dysphagia ( P <.01), cognitive dysfunction ( P <.01), severe MRS score ( P <.01), emotional incontinence ( P <.05), and depression ( P <.01). Caregiver factors related to high burden scores were being female ( P <.05), unemployment ( P <.01), being daughters-in-law ( P <.01), anxiety ( P <.01), depression ( P <.01), and long caregiving hours ( P <.05). On multivariate analysis, the most significant predictor for overall caregiver burden was caregiver anxiety followed by patient MRS score and caregivers being daughters-in-law. Caregiver depression, current employment status, and patient depression were also factors related to their burden.
Caregiver anxiety, patient physical deficits, and caregivers being daughter-in-law are important factors related to the caregiver burden in our population. Strategies to reduce caregiver burden should be developed based on understanding of these factors.
阐明韩国首尔中风幸存者中与照料者负担相关的因素。
横断面研究。
韩国一家大学医院的门诊。
我们随机选取了340名中风患者，并在中风后3年对他们进行评估。其中，最终对147名照料者和患者进行了访谈。
评估患者的人口统计学数据、神经症状、抑郁、情感失禁和改良Rankin量表（MRS）评分。此外，评估主要照料者的人口统计学数据、每天的照料时长、与患者的关系、健康状况、焦虑和抑郁情况以及是否有替代照料者。
用能力感问卷评估照料者负担，该问卷有3个亚领域，共27个条目。
与西方社会的报告相比，照料者负担得分较高。与负担得分相关的患者因素包括失业（P<.05）、患有糖尿病（P<.05）、失语（P<.01）、构音障碍（P<.05）、吞咽困难（P<.01）、认知功能障碍（P<.01）、MRS评分严重（P<.01）、情感失禁（P<.05）和抑郁（P<.01）。与高负担得分相关的照料者因素包括女性（P<.05）、失业（P<.01）、儿媳身份（P<.01）、焦虑（P<.01）、抑郁（P<.01）和照料时长较长（P<.05）。多因素分析显示，总体照料者负担的最显著预测因素是照料者焦虑，其次是患者的MRS评分和照料者的儿媳身份。照料者抑郁、当前就业状况和患者抑郁也是与其负担相关的因素。
照料者焦虑、患者身体缺陷和照料者的儿媳身份是我们研究人群中与照料者负担相关的重要因素。应基于对这些因素的理解制定减轻照料者负担的策略。
