Neurology, Public Health and Disability Unit, Scientific Directorate, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy.
Acta Neurol Scand. 2013 Jan;127(1):10-8. doi: 10.1111/j.1600-0404.2012.01666.x. Epub 2012 Apr 17.
To assess differences in the burden of caregivers of patients in Vegetative state (VS) and minimally conscious state (MCS).
The Family Strain Questionnaire, Coping Orientations to Problem Experiences, Caregiver Needs Assessment, Short Form-12, Beck Depression Inventory and State-Trait Anxiety Inventory were used. Differences in psychological condition between caregivers of VS and MCS patients, with different disease duration and hosting facility were assessed with Kruskall-Wallis test and factors associated with the overall levels of burden with UNIANOVA.
In total, 487 participants were enrolled. Daily hours of care-giving is significantly associated with the overall level of burden perceived by caregivers (F = 4.099; P = 0.018). Strain, needs and frequency of use of coping strategies are substantially similar regardless of the patient's condition and distance from the acute event. Caregivers of post-acute patients reported low scores in mental health (median = 33.8; IQR = 23.1-47.6) and higher state of anxiety (median = 54; IQR = 45-62), whereas caregivers of long-term patients expressed more needs in social involvement (median = 19; IQR = 15-22).
Burden and distress were high for all caregivers of VS and MCS patients. As care-giving is a long-term commitment process, support to the caregiver should be guaranteed throughout the duration of the relative's disease despite the patient's diagnosis or place where the patient is hosted.
评估处于植物状态(VS)和最小意识状态(MCS)的患者的照顾者的负担差异。
使用家庭负担问卷、应对问题的取向、照顾者需求评估、简短形式 12 项健康调查、贝克抑郁量表和状态-特质焦虑量表。采用 Kruskal-Wallis 检验评估 VS 和 MCS 患者的照顾者之间在心理状况上的差异,以及不同疾病持续时间和收容机构的差异,采用 UNIANOVA 分析与整体负担水平相关的因素。
共纳入 487 名参与者。每天的护理时间与照顾者感知到的整体负担水平显著相关(F=4.099;P=0.018)。无论患者的状况和与急性事件的距离如何,压力、需求和应对策略的使用频率都非常相似。急性后患者的照顾者的心理健康得分较低(中位数=33.8;IQR=23.1-47.6),状态焦虑得分较高(中位数=54;IQR=45-62),而长期患者的照顾者在社会参与方面的需求更多(中位数=19;IQR=15-22)。
VS 和 MCS 患者的所有照顾者的负担和痛苦都很高。由于护理是一个长期的承诺过程,即使患者的诊断或患者所在的收容机构不同,也应在患者患病期间为照顾者提供支持。