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创伤性脑损伤后照顾者的健康状况:一项多中心前瞻性调查

Caregivers' well-being after traumatic brain injury: a multicenter prospective investigation.

作者信息

Kreutzer Jeffrey S, Rapport Lisa J, Marwitz Jennifer H, Harrison-Felix Cynthia, Hart Tessa, Glenn Mel, Hammond Flora

机构信息

Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298-0542, USA.

出版信息

Arch Phys Med Rehabil. 2009 Jun;90(6):939-46. doi: 10.1016/j.apmr.2009.01.010.

Abstract

OBJECTIVE

To describe frequency and magnitude of caregivers' emotional distress and life satisfaction using standardized assessment procedures; compare distress levels among spouses, parents, and other caregivers; and identify risk factors.

DESIGN

Prospective collaborative cohort study.

SETTING

Six Traumatic Brain Injury Model System Centers providing neurotrauma care, rehabilitation, and outpatient follow-up.

PARTICIPANTS

Caregivers (N=273) of patients who were 1, 2, or 5 years postinjury.

INTERVENTIONS

Acute neurotrauma care, inpatient interdisciplinary brain injury rehabilitation, and postacute services.

MAIN OUTCOME MEASURE

Brief Symptom Inventory-18 Depression, Anxiety, and Somatic dimensions.

RESULTS

Levels of Depression, Anxiety, and Somatic symptoms were equally prevalent, with 1 in 5 caregivers scoring above the cutoff in each area. The proportion of participants with 1, 2, and 3 elevations was 17.9%, 5.5%, and 10.6%, respectively. Conversely, approximately two thirds (65.9%) had no scores exceeding cutoffs. Distress levels among spouses, parents, and other caregivers were comparable. Higher caregiver distress was associated with caring for survivors who had worse functional status, received more supervision, were less satisfied with life, and used alcohol excessively.

CONCLUSIONS

Depression, Anxiety, and Somatic symptoms are common among caregivers. Findings substantiate the importance of clinical care systems addressing the needs of caregivers in the long term as well as survivors.

摘要

目的

采用标准化评估程序描述照顾者情绪困扰和生活满意度的频率及程度;比较配偶、父母和其他照顾者的困扰水平;并确定风险因素。

设计

前瞻性协作队列研究。

地点

六个提供神经创伤护理、康复和门诊随访的创伤性脑损伤模型系统中心。

参与者

受伤后1年、2年或5年患者的照顾者(N = 273)。

干预措施

急性神经创伤护理、住院跨学科脑损伤康复和急性后期服务。

主要结局指标

简明症状量表-18抑郁、焦虑和躯体维度。

结果

抑郁、焦虑和躯体症状水平同样普遍,每五个照顾者中就有一个在每个领域的得分高于临界值。有1项、2项和3项指标升高的参与者比例分别为17.9%、5.5%和10.6%。相反,约三分之二(65.9%)的参与者得分未超过临界值。配偶、父母和其他照顾者的困扰水平相当。照顾者的较高困扰与照顾功能状态较差、接受更多监督、对生活不太满意且过度饮酒的幸存者有关。

结论

抑郁、焦虑和躯体症状在照顾者中很常见。研究结果证实了临床护理系统长期关注照顾者以及幸存者需求的重要性。

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