Mackenzie Corey S, Smith Marilyn C, Hasher Lynn, Leach Larry, Behl Pearl
Department of Counselling Psychology, OISE/University of Toronto, Baycrest Centre, Toronto, Ontario, Canada.
J Palliat Med. 2007 Jun;10(3):749-58. doi: 10.1089/jpm.2006.0171.
Caring for a terminally ill family member can be extremely stressful, and stress is known to have a negative influence on aspects of cognition. In contrast to the well-known physical and mental health risks associated with caregiving, little is known about its impact on cognitive functioning.
The primary objective of this study was to explore cognition among caregivers of palliative family members with a battery of neuropsychological tests. A secondary objective was to examine changes in cognition following caregiving by retesting a subset of participants at least 6 months after the death of their care recipient.
While caregiving, 27 participants completed an assessment battery measuring attention, learning, and memory, as well as intelligence, mood, and general health; 22 participants completed this battery again post-caregiving. We compared caregivers' cognitive performance to healthy normative samples.
Participants who were caring for palliative relatives exhibited significant impairments in attention, including difficulty monitoring their performance and regulating their attentional resources. In contrast, participants' episodic and working memory performance was not impaired while caregiving. A mixed pattern of improvement and worsening of cognitive functioning was evident among caregivers retested after their family member's death.
In addition to the well-documented physical and mental health risks associated with caregiving, this study adds to a small body of literature demonstrating impaired cognitive functioning among family members providing end-of-life care. Secondary findings of both improvement and deterioration of cognition post caregiving provide tentative support for the possibility of reversing certain cognitive deficits by reducing caregiver stress.
照顾身患绝症的家庭成员会带来极大压力，且已知压力会对认知的各个方面产生负面影响。与众所周知的与照顾相关的身心健康风险相比，人们对其对认知功能的影响知之甚少。
本研究的主要目的是通过一系列神经心理学测试来探索姑息治疗患者家属的认知情况。次要目的是在照顾对象去世至少6个月后对部分参与者进行重新测试，以检查照顾后认知的变化。
在照顾期间，27名参与者完成了一组评估测试，测量注意力、学习、记忆以及智力、情绪和总体健康状况；22名参与者在照顾结束后再次完成了该组测试。我们将照顾者的认知表现与健康的正常样本进行了比较。
照顾姑息治疗亲属的参与者在注意力方面表现出显著受损，包括难以监控自己的表现和调节注意力资源。相比之下，参与者在照顾期间的情景记忆和工作记忆表现并未受损。在照顾对象去世后接受重新测试的照顾者中，认知功能改善和恶化的混合模式很明显。
除了与照顾相关的已充分记录的身心健康风险外，本研究还补充了一小部分文献，表明在提供临终关怀的家庭成员中存在认知功能受损的情况。照顾后认知改善和恶化的次要发现为通过减轻照顾者压力来逆转某些认知缺陷的可能性提供了初步支持。
