Gort Ana M, Mingot Maria, Gomez Xavier, Soler Teodoro, Torres Gerard, Sacristán Oscar, Miguelsanz Santiago, Nicolas Francisco, Perez Ana, de Miguel Mariano, Cabau Jacinto
Departament de Medicina, Universitat de Lleida, Unidad de Investigación Biomédica, Hospital Santa Maria, Gestió de Serveis Sanitaris, Lleida, Spain.
Int J Geriatr Psychiatry. 2007 Oct;22(10):957-62. doi: 10.1002/gps.1770.
The main objective was to analyse the Zarit scale's (ZS) ability to identify signs of caregiver collapse amongst people looking after patients suffering from dementia. We also evaluated the dimensions most affected by the ZS and risk factors associated with caregiver burden and collapse.
We administered the ZS and semi-structured interviews to identify signs of caregiver collapse amongst 66 people looking after patients suffering from dementia. We evaluated the risk factors associated with the patient: age, sex, type of dementia, place of residence, length of illness, behavioural disorders, incontinence, the Barthel index (IB), the Global Deterioration Scale (GDS), Folstein's Mini-Mental State Examination (MMSE) and the use of day-care centres and also risk factors associated with the caregiver: age, sex, relationship with the patient, help received with caring, the patient's illness, other family responsibilities and other work outside the home.
There was a large degree of agreement between the findings from the interview and the ZS (Kappa = 0.545; p < 0.001). With regard to the risk factors evaluated in this study, there was a statistically significant relationship between behavioural disorders and both burden (p < 0.27) and collapse (p < 0.17) and between caregiver collapse and the caregiver and patient not living at the same home (p < 0.27).
The ZS is not only useful for identifying caregiver burden, but also for predicting main caregiver collapse. Behavioural disorders and not living with the patient are the main causes of caregiver burden and collapse.
主要目的是分析 Zarit 量表（ZS）识别痴呆症患者照料者出现崩溃迹象的能力。我们还评估了受 ZS 影响最大的维度以及与照料者负担和崩溃相关的风险因素。
我们对 66 名痴呆症患者的照料者进行了 ZS 测试和半结构化访谈，以识别照料者崩溃的迹象。我们评估了与患者相关的风险因素：年龄、性别、痴呆类型、居住地点、患病时长、行为障碍、失禁、巴氏指数（IB）、总体衰退量表（GDS）、福斯廷简易精神状态检查表（MMSE）以及日托中心的使用情况，还评估了与照料者相关的风险因素：年龄、性别、与患者的关系、照料时获得的帮助、患者的病情、其他家庭责任以及家庭以外的其他工作。
访谈结果与 ZS 结果之间存在高度一致性（卡帕值 = 0.545；p < 0.001）。关于本研究中评估的风险因素，行为障碍与负担（p < 0.27）和崩溃（p < 0.17）之间以及照料者崩溃与照料者和患者不住在同一家庭之间（p < 0.27）存在统计学上的显著关系。
ZS 不仅有助于识别照料者负担，还可用于预测主要照料者的崩溃。行为障碍以及与患者不住在一起是照料者负担和崩溃的主要原因。
