College of Medicine, Rush University, Chicago, Illinois, USA.
J Am Geriatr Soc. 2010 Dec;58(12):2315-22. doi: 10.1111/j.1532-5415.2010.03177.x. Epub 2010 Nov 18.
To examine caregiver burden over time in caregivers of patients with advanced chronic disease.
Observational cohort with interviews over 12 months.
Community.
Caregivers of 179 community-living persons aged 60 and older with advanced cancer, heart failure (HF), or chronic obstructive pulmonary disease (COPD).
Caregiver burden was assessed using a short-form of the Zarit Burden Inventory to measure psychosocial distress.
At baseline, the median caregiver burden was 5 (interquartile range (IQR) 1-11), which indicates that the caregiver endorsed having at least two of 10 distressing concerns at least some of the time. Only 10% reported no burden. Although scores increased modestly over time, the association between time and burden was not significant in longitudinal multivariable analysis. High burden was associated with caregiver need for more help with daily tasks (odds ratio (OR)=23.13, 95% confidence interval (CI)=5.94-90.06) and desire for greater communication with the patient (OR=2.53, 95% CI=1.16-5.53). The longitudinal multivariable analysis did not yield evidence of associations between burden and patient sociodemographic or health characteristics.
Caregiver burden was common in caregivers of patients with cancer, HF, and COPD. High burden was associated with the caregiver's report of need for greater help with daily tasks but not with objective measures of the patient's need for assistance, such as symptoms or functional status, suggesting that burden may be a measure of the caregiver's ability to adapt to the caregiving role.
考察晚期慢性疾病患者照顾者的照顾负担随时间的变化情况。
12 个月随访的观察性队列研究。
社区。
179 名年龄在 60 岁及以上、居住在社区中、患有晚期癌症、心力衰竭（HF）或慢性阻塞性肺疾病（COPD）的患者的照顾者。
使用 Zarit 负担量表的简短版本评估照顾者的负担，以衡量心理社会困扰。
基线时，照顾者的中位数负担为 5（四分位距（IQR）1-11），这表明照顾者至少在 10 个困扰问题中的两个问题上至少有些时候表示认同。只有 10%的人报告没有负担。尽管分数随时间略有增加，但纵向多变量分析中时间与负担之间的关联并不显著。高负担与照顾者对日常任务更多帮助的需求相关（比值比（OR）=23.13，95%置信区间（CI）=5.94-90.06），与与患者进行更多沟通的愿望相关（OR=2.53，95%CI=1.16-5.53）。纵向多变量分析并未发现负担与患者社会人口统计学或健康特征之间存在关联的证据。
癌症、HF 和 COPD 患者的照顾者中普遍存在照顾负担。高负担与照顾者报告需要更多的日常帮助有关，但与患者需要帮助的客观指标（如症状或功能状态）无关，这表明负担可能是照顾者适应照顾角色的能力的衡量标准。
