Brown L J, Potter J F, Foster B G
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-5620.
J Am Geriatr Soc. 1990 Apr;38(4):455-60. doi: 10.1111/j.1532-5415.1990.tb03545.x.
This study examines the relationship between caregiver burden and use of long-term care services following geriatric assessment. One hundred nine older subjects underwent comprehensive assessment, which included a questionnaire completed by the primary caregiver to assess the sense of burden in providing care. Logistic regression was used to identify independent predictors of service use at 12 months. Among measures of the older person's cognitive and physical abilities, only activities of daily living predicted increased use of services. When the measure of caregiver burden was added, it also entered as an independent predictor, which significantly improved the prediction of service use (chi 2 = 5.9, P less than .02). In a separate analysis, caregiver burden predicted both the use of home services and nursing-home placement. During longitudinal follow-up, the measure of burden decreased over 12 months for the sample, with the greatest reduction in burden occurring for caregivers whose relative was placed in a nursing home. The fact that caregiver burden was the most important factor in determining who would use formal services suggests that burden should be evaluated as part of geriatric assessment.
本研究探讨老年评估后照顾者负担与长期护理服务使用之间的关系。109名老年受试者接受了全面评估，其中包括由主要照顾者填写的一份问卷，以评估提供护理时的负担感。采用逻辑回归来确定12个月时服务使用的独立预测因素。在老年人认知和身体能力的测量指标中，只有日常生活活动能力可预测服务使用的增加。当加入照顾者负担测量指标时，它也作为一个独立预测因素进入模型，显著改善了对服务使用的预测（卡方=5.9，P<0.02）。在另一项分析中，照顾者负担可预测家庭服务的使用和养老院安置情况。在纵向随访期间，样本的负担测量指标在12个月内有所下降，其中亲属被安置在养老院的照顾者负担减轻幅度最大。照顾者负担是决定谁会使用正规服务的最重要因素，这一事实表明，应将负担评估作为老年评估的一部分。
