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智力残疾患者伴有和不伴有精神障碍者的临床和功能变量与家庭负担的关系。

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder.

机构信息

Parc Sanitari Sant Joan de Déu, Barcelona, Spain.

出版信息

Res Dev Disabil. 2012 May-Jun;33(3):796-803. doi: 10.1016/j.ridd.2011.12.002. Epub 2012 Jan 11.

Abstract

Few studies have been found that to assess the factors that explain higher levels of family burden in adults with intellectual disability (ID) and intellectual disability and mental disorders (ID-MD). The aims of this study were to assess family burden in people with ID and ID-MD and to determine which sociodemographic, clinical and functional disability variables account for family burden. The sample is composed of pairs of 203 participants with disability and their caregivers, of which 33.5% are caregivers of people with ID and 66.5% of ID-MD. Assessments were performed using scales of clinical and functional disability as the following instruments: Weschler Adult Intelligence Scale-III (WAIS-III), Inventory for Client and Agency Planning (ICAP), Psychiatric Assessment Schedule for Adults with Development Disability (PAS-ADD checklist), Disability Assessment Schedule of the World Health Organization (WHO-DAS-II) and family burden (Subjective and Objective Family Burden Inventory - SOFBI/ECFOS-II). People with ID-MD presented higher levels of functional disability than those with ID only. Higher levels of family burden were related to higher functional disability in all the areas (p<0.006-0.001), lower intelligence quotient (p<0.001), diagnosis of ID-MD (p<0.001) and presence of organic, affective, psychotic and behavioral disorders (p<0.001). Stepwise multiple regression showed that behavioral problems, affective and psychotic disorder, disability in participation in society, disability in personal care and presence of ID-MD explained more than 61% of the variance in family burden. An integrated approach using effective multidimensional interventions is essential for both people with ID and ID-MD and their caregivers in order to reduce family burden.

摘要

目前发现的研究很少,无法评估导致智力残疾(ID)和智力残疾伴精神障碍(ID-MD)成年人家庭负担水平更高的因素。本研究旨在评估 ID 和 ID-MD 患者的家庭负担,并确定哪些社会人口学、临床和功能残疾变量会导致家庭负担。样本由 203 对残疾人和他们的照顾者组成,其中 33.5%是 ID 患者的照顾者,66.5%是 ID-MD 患者的照顾者。使用临床和功能残疾量表评估,以下是评估的工具:韦氏成人智力量表第三版(WAIS-III)、客户和机构计划清单(ICAP)、成人发育障碍精神病学评估量表(PAS-ADD 清单)、世界卫生组织残疾评估量表(WHO-DAS-II)和家庭负担(主观和客观家庭负担量表- SOFBI/ECFOS-II)。ID-MD 患者的功能残疾水平高于仅 ID 患者。家庭负担水平与所有领域的功能残疾程度更高相关(p<0.006-0.001),智力水平较低(p<0.001)、ID-MD 诊断(p<0.001)以及存在器质性、情感、精神病和行为障碍(p<0.001)。逐步多元回归显示,行为问题、情感和精神病障碍、参与社会活动的残疾、个人护理的残疾以及 ID-MD 的存在,可解释家庭负担 61%以上的变异性。对于 ID 和 ID-MD 患者及其照顾者,采用有效的多维干预的综合方法,对于减轻家庭负担至关重要。

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