1 School of Health and Related Research, University of Sheffield , Sheffield, United Kingdom .
J Palliat Med. 2013 Dec;16(12):1602-9. doi: 10.1089/jpm.2013.0211. Epub 2013 Nov 16.
The diagnosis of motor neurone disease (MND) has a profound effect on the functioning and well-being of both the patient and their family, with studies describing an increase in carer burden and depression as the disease progresses.
This study aimed to assess whether patient use of noninvasive ventilation (NIV) impacted on their family carer, and to explore other sources of carer burden.
The study used qualitative interviews and scaled measures of carer health and well-being completed at three monthly intervals until patient end of life.
Sixteen family carers were followed up over a period ranging from one month to two years.
NIV was perceived as having little impact on carer burden. The data however highlighted a range of sources of other burdens relating to the physical strain of caring. The Medical Outcomes Study Short Form (SF-36 Health Survey) Physical Component Summary (PCS) scores were considerably below that of the Mental Component Summary (MCS) score at baseline and at all following time points. Carers described the physical effort associated with patient care and role change; the challenge inherent in having time away; and problems relating to the timing of equipment and service delivery.
NIV can be recommended to patients without concerns regarding increasing carer burden. The predominant source of burden described related to the physical impact of caring for a patient with MND. Services face challenges if this physical burden is to be reduced by providing equipment at an optimal time and successfully coordinating their input.
运动神经元病(MND)的诊断对患者及其家庭的功能和福祉都有深远的影响,研究表明随着疾病的进展,照顾者的负担和抑郁会增加。
本研究旨在评估患者使用无创通气(NIV)是否会对其家庭照顾者产生影响,并探讨其他照顾者负担的来源。
该研究使用定性访谈和照顾者健康和福祉的量表评估,每三个月进行一次,直到患者生命结束。
16 名家庭照顾者在一个月到两年的时间内进行了随访。
NIV 被认为对照顾者负担影响不大。然而,数据突出了与照顾相关的身体疲劳有关的一系列其他负担的来源。在基线和所有后续时间点,医疗结局研究短表(SF-36 健康调查)生理成分综合评分(PCS)明显低于心理成分综合评分(MCS)。照顾者描述了与患者护理和角色变化相关的身体努力、离开时间所固有的挑战以及与设备和服务交付时间有关的问题。
可以向患者推荐使用 NIV,而不必担心增加照顾者的负担。描述的主要负担来源与照顾 MND 患者的身体影响有关。如果要通过在最佳时间提供设备并成功协调其投入来减轻这种身体负担,服务将面临挑战。