Clipp E C, George L K
Geriatric Research, Education and Clinical Center, Durham VA Medical Center, NC 27705.
J Am Geriatr Soc. 1990 Mar;38(3):227-35. doi: 10.1111/j.1532-5415.1990.tb03496.x.
The majority of research on "caregiver burden" focuses on mental health consequences. These stresses are associated with psychotropic drug use among some caregivers. The purposes of this paper are to identify the correlates of psychotropic drug use among caregivers of demented older adults and to determine whether or not certain types of psychotropics (ie, antianxiety, antidepressant, and sedative/hypnotic agents) have common or unique correlates. The prevalence of psychotropic drug use among caregivers in the sample (n = 510) is substantially higher than previously reported prevalence rates in the general population and among community-dwelling elderly. Using logistic regression techniques, caregiver characteristics (eg, gender, health, relationship to the patient) rather than severity of the patient's condition emerge as predictors of antianxiety, antidepressant, and sedative/hypnotic use. The caregiver's perception of how well he or she is supported in the caregiving role emerges as an important correlate of psychotropic drug use in general and especially of antidepressant consumption. Results suggest that caregivers are a high-risk group for the development of emotional symptoms such as nervousness, exhaustion, decreased appetite, and difficulty sleeping, symptoms that may or may not constitute a psychiatric disorder. Characteristics of the caregiver, especially aspects of the support system, should be important considerations in decisions to prescribe psychotropic drugs.
大多数关于“照料者负担”的研究都聚焦于心理健康方面的影响。这些压力与一些照料者使用精神药物有关。本文的目的是确定老年痴呆患者照料者使用精神药物的相关因素,并确定某些类型的精神药物(即抗焦虑药、抗抑郁药和镇静/催眠药)是否有共同的或独特的相关因素。样本中(n = 510)照料者使用精神药物的比例显著高于先前报道的普通人群和社区居住老年人中的患病率。使用逻辑回归技术,照料者的特征(如性别、健康状况、与患者的关系)而非患者病情的严重程度成为抗焦虑药、抗抑郁药和镇静/催眠药使用的预测因素。照料者对自己在照料角色中得到支持程度的认知成为总体上尤其是抗抑郁药使用的精神药物使用的一个重要相关因素。结果表明,照料者是出现紧张、疲惫、食欲减退和睡眠困难等情绪症状的高危人群,这些症状可能构成也可能不构成精神障碍。照料者的特征,尤其是支持系统的各个方面,在决定开具精神药物时应作为重要考虑因素。