Jackson Diana, Turner-Stokes Lynne, Murray Joanna, Leese Morven, McPherson Kathryn M
Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, London, UK.
Brain Inj. 2009 May;23(5):433-44. doi: 10.1080/02699050902788451.
As their differential needs are unknown and to inform service planning, this study (a) examined experiences of caring for adults with acquired brain injury (ABI) and (b) compared these with carers of adults with dementia.
Cross-sectional postal survey. ABI carer experiences were compared with those of a previously studied group of dementia carers using equivalent instruments.
Family carers (n = 222) of adults with ABI: TBI (49%), strokes (26%), brain infections (18%) and other (7%) completed validated questionnaires assessing physical dependency and psychological problems of those cared for and carers' own perceived burden, quality-of-life and mental health.
Carer burden, quality-of-life and mental health were worse for ABI carers, but were not predicted by gender, relationship, injury type, physical dependency or cognitive problems in either ABI or dementia carers. Behavioural problems of those cared for varied between the two groups and affected carers differently. Aggressive problems significantly predicted greater burden, poor quality-of-life and mental health in ABI carers, whereas passivity/low mood significantly predicted greater burden and worse quality-of-life in dementia carers.
This study revealed different experiences of caring for younger adults with ABI vs. older adults with dementia, thereby supporting targeted development of services to sustain families affected by these conditions.
由于对后天性脑损伤(ABI)成年患者的不同护理需求尚不明确,且为服务规划提供依据,本研究(a)调查了照顾后天性脑损伤成年患者的经历,(b)并将这些经历与痴呆症成年患者的护理者进行比较。
横断面邮寄调查。使用同等工具,将ABI患者护理者的经历与先前研究的一组痴呆症患者护理者的经历进行比较。
222名ABI成年患者的家庭护理者:创伤性脑损伤(TBI)患者占49%,中风患者占26%,脑部感染患者占18%,其他患者占7%,完成了经过验证的问卷,评估所照顾患者的身体依赖性和心理问题以及护理者自身感知到的负担、生活质量和心理健康状况。
ABI患者护理者的护理负担、生活质量和心理健康状况较差,但在ABI患者护理者或痴呆症患者护理者中,性别、关系、损伤类型、身体依赖性或认知问题均无法预测这些情况。两组中所照顾患者的行为问题各不相同,对护理者的影响也不同。攻击性行为问题显著预示着ABI患者护理者负担更重、生活质量差和心理健康状况不佳,而被动/情绪低落则显著预示着痴呆症患者护理者负担更重、生活质量更差。
本研究揭示了照顾年轻ABI成年患者与老年痴呆症成年患者的不同经历,从而支持有针对性地发展服务,以维持受这些疾病影响的家庭。