Halm Margo A, Treat-Jacobson Diane, Lindquist Ruth, Savik Kay
United Hospital, St. Paul, Minnesota 55102, USA.
Nurs Res. 2006 Nov-Dec;55(6):426-36. doi: 10.1097/00006199-200611000-00007.
Coronary artery bypass (CAB) patients often rely on spouses for care and assistance during recovery after surgery. Caregiving can be stressful and meaningful depending upon the interplay of many factors not completely understood. These factors may affect the spouse caregiver's health-related quality of life (HRQL), which may impact ability to care for the CAB patient.
To investigate patient-spouse caregiver relationship and role variables associated with caregiver burden during the first year after CAB surgery.
Using a cross-sectional design, a convenience sample of CAB spouses was recruited at 3, 6, or 12 months. Spouses (n = 166) completed a survey that included perceptions of patient health status, caregiver burden and other caregiving variables, and caregiver HRQL.
Higher burden scores were associated with patient's gender (female), poorer patient health status, lower caregiver mental HRQL, increased personal gain, and increased caregiver competence. These correlates explained 38% of the variance in caregiver burden.
Only poorer patient health status and lower caregiver mental HRQL were supported by previous research in this population. Positive relationships between burden and caregiver competence and personal gain may be a reflection that spouse caregivers were invested and working hard. They felt satisfied from enhancement of self but were burdened from their caregiving role, providing support for a previously described two-domain caregiving model. Caregiver screening is essential to identify spouses at high risk for negative outcomes. Longitudinal research is needed to identify the correlates and predictors most likely to influence burden and caregiver gain over time, and to more fully understand caregiving in the CAB population.
冠状动脉搭桥术(CAB)患者在术后康复期间通常依赖配偶提供护理和帮助。护理工作可能会带来压力,其意义也取决于许多尚未完全了解的因素之间的相互作用。这些因素可能会影响配偶护理者的健康相关生活质量(HRQL),进而可能影响其照顾CAB患者的能力。
调查CAB手术后第一年患者与配偶护理者之间的关系以及与护理者负担相关的角色变量。
采用横断面设计,在术后3个月、6个月或12个月招募了CAB患者配偶的便利样本。配偶(n = 166)完成了一项调查,内容包括对患者健康状况的看法、护理者负担及其他护理变量,以及护理者的HRQL。
较高的负担得分与患者性别(女性)、较差的患者健康状况、较低的护理者心理HRQL、增加的个人收获以及增强的护理者能力相关。这些相关因素解释了护理者负担差异的38%。
在该人群的先前研究中,仅较差的患者健康状况和较低的护理者心理HRQL得到了支持。负担与护理者能力和个人收获之间的正相关关系可能反映出配偶护理者全身心投入且努力工作。他们从自我提升中感到满足,但却因护理角色而负担沉重,这为先前描述的双领域护理模式提供了支持。对护理者进行筛查对于识别有负面结果高风险的配偶至关重要。需要进行纵向研究,以确定随着时间推移最有可能影响负担和护理者收获的相关因素和预测因素,并更全面地了解CAB人群中的护理情况。