Boston Medical Center, Boston, Massachusetts; School of Medicine, Boston University, Boston, Massachusetts.
J Am Geriatr Soc. 2014 Feb;62(2):276-84. doi: 10.1111/jgs.12657. Epub 2014 Feb 6.
To describe the factors associated with burden that caregivers of cognitively impaired older adults (dementia, delirium, or both) at the time of hospitalization experienced.
Cross-sectional data analyses.
Three hospitals-one academic tertiary hospital and two associated community hospitals.
Caregivers (N = 495) of cognitively impaired older adults at the time of hospital admission.
Multivariable linear regression was performed to analyze the effect of the independent variables (caregiver: demographic characteristics, depressive symptoms, self-efficacy; older adult: neuropsychiatric symptoms, delirium, functional deficits) on caregiver burden.
Higher burden was associated with younger caregiver age (P = .02), being a spouse (P = .03), depressive symptoms (P < .001), caregivers' lower perceived self-efficacy in managing care recipient symptoms (P = .002), and limited finances at the end of the month (P = .01). Caregiver burden was also strongly associated with the care recipient factors distressing neuropsychiatric symptoms (P = .001), delirium (P = .001), and greater functional deficits in basic activities of daily living (P = .001).
These findings suggest that caregivers of older adults who were cognitively impaired at hospital admission experience burden. Understanding the factors that contribute to burden at the time of hospitalization for caregivers of persons with cognitive impairment can inform the development of interventions targeted throughout the hospitalization that have the potential to decrease burden.
描述认知障碍老年人(痴呆、谵妄或两者兼有)住院时其照顾者所经历的负担相关因素。
横断面数据分析。
三家医院——一家学术型三级医院和两家附属社区医院。
认知障碍老年人的照顾者(N=495),在入院时。
多变量线性回归分析用于分析独立变量(照顾者:人口统计学特征、抑郁症状、自我效能;老年人:神经精神症状、谵妄、功能缺陷)对照顾者负担的影响。
更高的负担与照顾者年龄较小(P=0.02)、配偶关系(P=0.03)、抑郁症状(P<0.001)、照顾者对管理护理对象症状的自我效能感较低(P=0.002)以及月底资金有限(P=0.01)相关。照顾者负担也与照顾对象的困扰性神经精神症状(P=0.001)、谵妄(P=0.001)以及日常生活基本活动功能缺陷更大(P=0.001)密切相关。
这些发现表明,认知障碍老年人住院时,其照顾者会经历负担。了解认知障碍患者照顾者在住院期间负担的相关因素,可以为整个住院期间的干预措施的制定提供信息,这些干预措施有可能减轻负担。