Neubauer Simone, Holle Rolf, Menn Petra, Grässel Elmar
Helmholtz Zentrum München, German Research Center for Environmental Health GmbH,Institute of Health Economics and Health Care Management, Germany.
Int J Geriatr Psychiatry. 2009 Mar;24(3):275-82. doi: 10.1002/gps.2103.
An economic evaluation of dementia-related interventions from a societal perspective should take account of informal caregiving. We assessed informal caregiving time and report our findings on the validity and stability of our results.
Within the German IDA study ('Dementia Care Initiative in Primary Practice'), informal care time for people with dementia living at home is assessed. We applied a German adaptation of the Resource Utilization in Dementia (RUD) questions on informal care, which distinguishes three categories of informal care activities: Activities of Daily Living (ADL), Instrumental ADL (IADL), and supervision. In contrast to the original version, we included the time of all informal caregivers who are involved in caring for the patient. The questionnaire was completed as a computer-assisted telephone interview at baseline and after 1 year. To test the plausibility of the questionnaire, we proposed seven hypotheses about the reported informal care time.
Nearly all results confirmed our hypotheses. Informal care time as well as changes over time correlated with the physical and mental health status of the patient. Considering the time of other informal caregivers led to slightly higher correlations (not significant). The results indicate that interviewees seem to underestimate particularly the time of supervision of other informal caregivers.
In sum, the instrument gives plausible results and is suited for measuring informal care time, as well as changes over time. If it is not possible to directly interview each caregiver involved, it is of great importance to identify and interview the primary informal caregiver in order to prevent an underestimation of total informal care time.
从社会角度对痴呆相关干预措施进行经济评估时应考虑非正式照护情况。我们评估了非正式照护时间，并报告了结果的有效性和稳定性。
在德国的IDA研究（“初级医疗中的痴呆症护理倡议”）中，对居家痴呆患者的非正式照护时间进行了评估。我们采用了德国版的痴呆症资源利用（RUD）中关于非正式照护的问题，该问题区分了三类非正式照护活动：日常生活活动（ADL）、工具性日常生活活动（IADL）和监督。与原始版本不同的是，我们纳入了所有参与患者照护的非正式照护者的时间。该问卷在基线时和1年后通过计算机辅助电话访谈完成。为检验问卷的合理性，我们提出了七个关于所报告的非正式照护时间的假设。
几乎所有结果都证实了我们的假设。非正式照护时间以及随时间的变化与患者的身心健康状况相关。考虑其他非正式照护者的时间会导致相关性略高（不显著）。结果表明，受访者似乎尤其低估了其他非正式照护者的监督时间。
总之，该工具得出的结果合理，适用于测量非正式照护时间以及随时间的变化。如果无法直接访谈每位参与的照护者，识别并访谈主要的非正式照护者以防止低估总非正式照护时间非常重要。
