Neubauer Simone, Holle Rolf, Menn Petra, Grossfeld-Schmitz Maria, Graesel Elmar
Helmholtz Zentrum München, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Int Psychogeriatr. 2008 Dec;20(6):1160-76. doi: 10.1017/S1041610208007564. Epub 2008 Jul 8.
Previous assessments of informal care time have tended to consider only the amount of time spent with the patient by the primary informal caregiver; however, in many cases, more than one person is providing care for the patient. We assess total informal care time of people caring for patients with dementia, and estimate the bias that can arise if consideration is not made of the time spent by all participating informal caregivers.
We used an extended version of the questions on informal care time from the Resource Utilization in Dementia (RUD) instrument. Caregivers were asked to state the number of days and the number of hours on a typical day they had assisted the patient in activities of daily living (ADL), instrumental ADL (IADL), and supervision during the last four weeks. Multivariate regression analyses were conducted to identify factors that could account for the amount of informal care time.
357 informal caregivers took part. Values were missing from only 4.5% of all interviews. On average, the primary informal caregiver cared for the patient 1.5, 2.1 and 1.9 hours per day in ADL, IADL and supervision respectively. Fifty-seven percent of all patients had more than one informal caregiver. Total informal care time was underestimated by about 14% if the time of caregivers other than the primary caregiver was not taken into account. The informal care time was significantly higher if the caregiver was the patient's partner and the patient's health status was lower.
Our results show that most previous studies probably underestimated costs of informal care because the time of informal caregivers other than the primary caregiver was not considered.
以往对非正式护理时间的评估往往只考虑主要非正式护理人员陪伴患者的时间;然而,在许多情况下,不止一人为患者提供护理。我们评估了照顾痴呆症患者的人员的总非正式护理时间,并估计了如果不考虑所有参与的非正式护理人员所花费的时间可能产生的偏差。
我们使用了痴呆症资源利用(RUD)工具中关于非正式护理时间问题的扩展版本。要求护理人员说明在过去四周内他们协助患者进行日常生活活动(ADL)、工具性日常生活活动(IADL)以及监督的天数和每天的小时数。进行多变量回归分析以确定可能解释非正式护理时间量的因素。
357名非正式护理人员参与。所有访谈中仅有4.5%的值缺失。平均而言,主要非正式护理人员在ADL、IADL和监督方面每天分别照顾患者1.5小时、2.1小时和1.9小时。所有患者中有57%有不止一名非正式护理人员。如果不考虑主要护理人员以外的护理人员的时间,总非正式护理时间会被低估约14%。如果护理人员是患者的伴侣且患者健康状况较差,非正式护理时间会显著更高。
我们的结果表明,以往大多数研究可能低估了非正式护理的成本,因为没有考虑主要护理人员以外的非正式护理人员的时间。