Shibre Teshome, Medhin Germay, Teferra Solomon, Wakwoya Asfaw, Berhanu Elsabeth, Abdulahi Abdulreshid, Alem Atalay, Fekadu Abebaw
Addis Ababa University, Faculty of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia.
Ethiop Med J. 2012 Apr;50(2):125-33.
We assessed carer-burden and its predictors in a traditional rural Ethiopian community in order to establish the longitudinal course of carer-burden and factors predicting changes.
Using a 5-year follow-up data from the ongoing Butajira outcome study on SMI, carer-burden was assessed annually with the Family Interview Schedule (FIS). Multilevel modeling was used to identify clinical predictors of severity and rate of change of burden.
Scores in all domains of carer burden decreased over time, although the greatest reduction was seen in the first year. In a univariate analyses, longitudinal reduction in burden score was predicted by longer period in remission during follow-up, while negative and positive symptom severity scores predicted higher burden score. In the fully adjusted model, poor social support predicted higher burden score (beta=0.38, 95%CI 0.04, 0.72), and longer period in remission predicted lower level of carer-burden (beta = -0.49, 95%CI = -0.89, - 0.10). Reduction in positive symptoms was associated with the instantaneous rate of reduction of burden score (beta = -0.03, 95%CI - 0.05, -0.01).
There is a significant reduction in carer-burden over the years in all burden domains. Providing accessible mental health care has the potential to alleviate carer-burden, as positive symptoms are believed to be more amenable to intervention. The study also indicates that remission is associated with reduction in carer-burden.
我们评估了埃塞俄比亚一个传统农村社区中照顾者的负担及其预测因素，以确定照顾者负担的纵向变化过程以及预测变化的因素。
利用正在进行的关于严重精神疾病的布塔吉拉结局研究的5年随访数据，每年使用家庭访谈时间表（FIS）评估照顾者负担。采用多水平模型来确定负担严重程度和变化率的临床预测因素。
尽管在第一年下降幅度最大，但照顾者负担所有领域的得分随时间推移均有所下降。在单变量分析中，随访期间缓解期较长可预测负担得分的纵向降低，而阴性和阳性症状严重程度得分则预测更高的负担得分。在完全调整模型中，社会支持差预测更高的负担得分（β=0.38，95%置信区间0.04，0.72），缓解期较长预测照顾者负担水平较低（β = -0.49，95%置信区间 = -0.89，-0.10）。阳性症状的减轻与负担得分的即时降低率相关（β = -0.03，95%置信区间 -0.05，-0.01）。
多年来，所有负担领域的照顾者负担均有显著降低。提供可及的精神卫生保健有可能减轻照顾者负担，因为阳性症状被认为更易于干预。该研究还表明，缓解与照顾者负担的减轻相关。
