Tanji Haruko, Anderson Karen E, Gruber-Baldini Ann L, Fishman Paul S, Reich Stephen G, Weiner William J, Shulman Lisa M
Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Mov Disord. 2008 Oct 15;23(13):1843-9. doi: 10.1002/mds.22089.
To assess the association between mutuality of the marital relationship in Parkinson's disease with disease severity, disability, mental health, quality of life, and caregiver burden. Spouses of patients with PD completed questionnaires assessing mutuality of the marital relationship (Mutuality Scale) and caregiver strain (Caregiver Strain Index). Patients and spouses completed scales assessing their mental health (Brief Symptom Inventory-18), medical co-morbidity (Cumulative Illness Rating Scale) and health-related QoL (SF-12v2). PD severity and disability were assessed with the Unified Parkinson's Disease Rating Scale and the Older Americans Resource and Services Disability Scale. The relationships between mutuality and patient and spousal variables were analyzed with univariate correlations and multiple regression. Ninety-six spouse-patient pairs were assessed. Increased mutuality, as reported by the spouse was associated with reduced caregiver burden, less depression of both spouse and patient, and less PD severity. Mutuality was inversely correlated with gait impairment, with lesser correlations for balance, urinary incontinence and motor fluctuations. Greater mutuality between spouses and patients with PD is associated with better mental health of both partners, reduced caregiver burden and improved spousal quality of life. PD severity, especially gait, balance, urinary incontinence and motor fluctuations are particular stressors on the marital relationship.
评估帕金森病婚姻关系的相互性与疾病严重程度、残疾、心理健康、生活质量及照料负担之间的关联。帕金森病患者的配偶完成了评估婚姻关系相互性(相互性量表)和照料者压力(照料者压力指数)的问卷。患者及其配偶完成了评估其心理健康(简明症状量表-18)、合并症(累积疾病评定量表)及健康相关生活质量(SF-12v2)的量表。使用统一帕金森病评定量表和美国老年人资源与服务残疾量表评估帕金森病的严重程度和残疾情况。采用单变量相关性分析和多元回归分析相互性与患者及配偶变量之间的关系。对96对配偶-患者组合进行了评估。配偶报告的相互性增加与照料负担减轻、配偶和患者的抑郁减轻以及帕金森病严重程度降低相关。相互性与步态障碍呈负相关,与平衡、尿失禁和运动波动的相关性较小。帕金森病患者与其配偶之间更高的相互性与双方更好的心理健康、减轻的照料负担及改善的配偶生活质量相关。帕金森病的严重程度,尤其是步态、平衡、尿失禁和运动波动是婚姻关系的特殊压力源。