College of Nursing, University of Kentucky, Lexington, KY, USA.
J Cardiovasc Nurs. 2010 Sep-Oct;25(5):411-9. doi: 10.1097/JCN.0b013e3181d2a58d.
Millions of family members deliver informal care and support to patients with heart failure (HF). Caregivers of patients with HF experience depressive symptoms, but factors associated with depressive symptoms are unknown. The purposes of this study were (1) to examine differences between caregivers with and without depressive symptoms in patients' characteristics and caregivers' functional status, caregiving burden (time devoted to caregiving, difficulty of caregiving tasks, and overall perceived caregiving distress), and perceived control; and (2) to determine predictors of depressive symptoms of caregivers.
A total of 109 caregivers (mean age of 57 years; spousal caregiver, 79%) and patients with HF participated in this study. Depressive symptoms, perceived control, and functional status of both patients and caregivers were assessed using the Beck Depression Inventory II, the Control Attitudes Scale-Revised, and the Duke Activity Status Index, respectively. Caregivers' burden (time and difficulty of caregiving tasks and burden) were assessed using the Oberst Caregiving Burden Scale and the Zarit Burden Interview.
The 27.5% of HF caregivers with depressive symptoms (Beck Depression Inventory II score > or =14) had poorer functional status, lower perceived control, and higher perceived caregiving distress; experienced more caregiving difficulty; and spent more time in caregiving tasks than did caregivers without depressive symptoms. Controlling for age and sex in a multiple regression, caregivers' own functional disability (standard beta [sbeta] = -.307, P < .001), perceived control (sbeta = -.304, P < .001), and caregiver burden (sbeta = .316, P = .002) explained 45% of the variance in caregivers' depressive symptoms. Patients' New York Heart Association class and functional status did not predict caregivers' depressive symptoms.
Caregivers' poor functional status, overall perception of caregiving distress, and perceived control were associated with depressive symptoms. Depressed caregivers of patients with HF may benefit from interventions that improve caregivers' perceived control, address the caregiving burden, and improve or assist with caregivers' functional status.
数以百万计的家庭成员为心力衰竭（HF）患者提供非正式的护理和支持。HF 患者的照顾者会出现抑郁症状，但与抑郁症状相关的因素尚不清楚。本研究的目的是：（1）比较有无抑郁症状的 HF 患者照顾者在患者特征、照顾者功能状态、照顾负担（照顾时间、照顾任务难度和整体感知照顾压力）和感知控制方面的差异；（2）确定照顾者抑郁症状的预测因素。
共纳入 109 名照顾者（平均年龄 57 岁；配偶照顾者占 79%）和 HF 患者。使用贝克抑郁量表第二版、控制态度量表修订版和杜克活动状态指数分别评估患者和照顾者的抑郁症状、感知控制和功能状态。使用 Oberst 照顾负担量表和 Zarit 负担访谈评估照顾者的负担（照顾时间和难度以及负担）。
27.5%的 HF 照顾者（贝克抑郁量表第二版得分≥14）的功能状态较差，感知控制能力较低，感知照顾压力较大；经历更多的照顾困难；照顾任务时间也比没有抑郁症状的照顾者长。在多元回归中，控制年龄和性别后，照顾者自身的功能障碍（标准β[sbeta]=-.307，P<.001）、感知控制（sbeta=-.304，P<.001）和照顾者负担（sbeta=.316，P=.002）可以解释照顾者抑郁症状的 45%。患者纽约心脏协会（NYHA）心功能分级和功能状态不能预测照顾者的抑郁症状。
照顾者较差的功能状态、整体照顾压力感知和感知控制与抑郁症状相关。HF 患者抑郁的照顾者可能受益于干预措施，这些措施可以改善照顾者的感知控制、减轻照顾负担、改善或协助照顾者的功能状态。
