Medical School and Hospital de Base, São José do Rio Preto, São Paulo, Brazil.
Liver Transpl. 2010 Oct;16(10):1164-8. doi: 10.1002/lt.22130.
Over the last few decades, informal caregivers of patients with chronic diseases have received more attention, and there is a growing volume of studies demonstrating high rates of burden, stress, and mental disorders in this group of individuals. The objective of this study was to evaluate the burden, stress, and psychosocial characteristics of informal caregivers of liver transplantation candidates. Participants were assessed by individual evaluations with the following instruments: a semistructured interview, the Caregiver Burden Scale, the Inventário de Sintomas de Stress para Adultos de Lipp, and the Beck Depression Inventory. The Mann-Whitney test was used for statistical analysis with a significance level of 0.05. The characteristics of the study group (n = 61) were similar to those of groups in other studies with respect to gender (82% were women), kinship (64% were spouses), and age (the mean age was 47.6 years). The main stressors identified by the participants were as follows: doubts about ways to react in a crisis or in emergency situations (42.6%), mood swings of the patient (29.5%), and care involving food and medications (27.9%). Approximately 25% of the caregivers reported that they felt unprepared to adequately perform their roles. Data analysis indicated a greater burden overall on caregivers when the patient's Model for End-Stage Liver Disease score was greater than or equal to 15 points (P = 0.041). Furthermore, caregivers of patients with alcoholic liver disease showed higher depression (P = 0.034) and overall burden scores (P = 0.031) versus caregivers of patients with liver disease due to other etiologies. In conclusion, the participants showed significantly high levels of burden, stress, and depression. Support measures and caregiver preparation should be implemented by health care providers.
在过去几十年中,慢性疾病患者的非专业照护者受到了更多关注,越来越多的研究表明,这一群体的负担、压力和精神障碍发生率很高。本研究的目的是评估肝移植候选者非专业照护者的负担、压力和心理社会特征。参与者通过个体评估使用以下工具进行评估:半结构化访谈、照顾者负担量表、成人 Lipp 压力症状量表和贝克抑郁量表。使用曼-惠特尼检验进行统计分析,显著性水平为 0.05。研究组(n=61)的特征与其他研究中的组相似,性别(82%为女性)、亲属关系(64%为配偶)和年龄(平均年龄为 47.6 岁)。参与者确定的主要压力源如下:对危机或紧急情况下反应方式的怀疑(42.6%)、患者情绪波动(29.5%)以及涉及食物和药物的护理(27.9%)。大约 25%的照护者表示,他们觉得自己没有准备好充分履行自己的角色。数据分析表明,当患者的终末期肝病模型评分大于或等于 15 分时,照护者的总体负担更大(P=0.041)。此外,与患有其他病因引起的肝病的患者的照护者相比,患有酒精性肝病的患者的照护者表现出更高的抑郁(P=0.034)和整体负担评分(P=0.031)。总之,参与者的负担、压力和抑郁水平明显较高。卫生保健提供者应实施支持措施和照护者准备。