AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Physique et Réadaptation, Paris, France (Drs Bayen and Pradat-Diehl); Université Paris-Dauphine, Laboratoire d'Economie et de Gestion des Organisations de Santé (LEDa-LEGOS), Paris, France (Drs Bayen and Joël); Université Pierre et Marie Curie, UFR de médecine, Paris, France (Drs Bayen and Pradat-Diehl); Université Pierre et Marie Curie, Unité ER 6, Paris, France (Drs Pradat-Diehl, Jourdan and Azouvi); AP-HP, Hôpital R. Poincaré, Service de Médecine Physique et Réadaptation, Garches, France (Drs Jourdan and Azouvi); Université de Versailles St-Quentin, UFR de médecine, EA 4497, Guyancourt, France (Drs Jourdan and Azouvi); AP-HP, Hôpital A Paré, Unité de Recherche Clinique Paris-Ouest, Boulogne-Billancourt, France (Mr Ghout, Ms Bosserelle, Ms Azerad, and Dr Aegerter); Centre Ressources Francilien du Traumatisme Crânien, Paris, France (Ms Bosserelle, Ms Azerad, and Dr Weiss); and Université de Versailles St-Quentin, UPRES EA 2506, Guyancourt, France (Dr Aegerter).
J Head Trauma Rehabil. 2013 Nov-Dec;28(6):408-18. doi: 10.1097/HTR.0b013e31825413cf.
To investigate predictors of informal care burden 1 year after a severe traumatic brain injury (TBI).
Patients (N = 66) aged 15 years or older with severe TBI (Glasgow Coma Scale score of 8 or less) and their primary informal caregivers.
Multicenter inception cohort study over 22 months in Paris and the surrounding area (PariS-TBI study).
Patients' preinjury characteristics; injury severity data; outcome measures at discharge from intensive care and 1 year after the injury; Dysexecutive Questionnaire; Medical Outcome Study Short Form-36; Zarit Burden Inventory.
Among the 257 survivors at discharge from acute care, 66 patient-caregiver couples were included. Primary informal caregivers were predominantly women (73%), of middle age (age, 50 years), supporting male patients (79%), of mean age of 38 years. The majority (56%) of caregivers experienced significant burden, and 44% were at risk of depression. Caregivers' impaired health status and perceived burden significantly correlated with patients' global disability (as assessed with the Glasgow Outcome Scale-Extended) and impairments of executive functions (as assessed with the Dysexecutive Questionnaire). A focused principal component analysis suggested that disability and executive dysfunctions were independent predictors of perceived burden, whereas demographics, injury severity, and Glasgow Outcome Scale at discharge from acute care did not significantly correlate with caregiver's burden.
Global handicap and impairments of executive functions are independent significant predictors of caregiver burden 1 year after TBI.
探讨严重创伤性脑损伤（TBI）后 1 年非正规护理负担的预测因素。
年龄在 15 岁及以上的患者（N=66）患有严重 TBI（格拉斯哥昏迷量表评分为 8 或更低）及其主要非正规照顾者。
巴黎及周边地区 22 个月的多中心发病队列研究（PariS-TBI 研究）。
患者受伤前的特征；损伤严重程度数据；从重症监护出院和受伤后 1 年的预后评估；执行功能障碍问卷；医疗结局研究简表-36；Zarit 负担量表。
在急性护理出院的 257 名幸存者中，有 66 对患者-照顾者配对纳入研究。主要非正规照顾者主要是女性（73%），年龄在 50 岁左右，照顾男性患者（79%），年龄平均为 38 岁。大多数照顾者（56%）经历了显著的负担，44%有抑郁风险。照顾者健康状况受损和感知负担与患者的总体残疾（格拉斯哥预后量表-扩展评估）和执行功能障碍（执行功能障碍问卷评估）显著相关。一项集中的主成分分析表明，残疾和执行功能障碍是非正规护理者感知负担的独立预测因素，而人口统计学、损伤严重程度和急性护理出院时的格拉斯哥结局量表与照顾者的负担没有显著相关性。
在 TBI 后 1 年，整体残疾和执行功能障碍是照顾者负担的独立显著预测因素。
