Ren Hong, Yu Yan, Hu Jia-Yu, Shi Yang, Lu Yi-Han, Meng Wei
Department of Epidemiology, The Key Laboratory of Public Health Safety of Minister of Education, Fudan University School of Public Health, Building 8 Room 429,130 Dong'an Road, Shanghai 200032, China.
BMC Infect Dis. 2014 Feb 12;14:82. doi: 10.1186/1471-2334-14-82.
In China, caregivers of chronic viral hepatitis patients experience considerable burdens, stress and disruption of their own well-being and social activities. Measurement of the effect on caregivers is an under-researched area. The Family Burden Interview Schedule (FBIS) was primarily devised for the caregivers of schizophrenia patients, and the adverse effect of the disease was similar to the effect of chronic viral hepatitis on family caregivers. In this study, we prospectively evaluated the psychometric properties of FBIS in the field of chronic viral hepatitis and used it to determine the factors affecting the caregiver burden on the family members of chronic viral hepatitis patients in Shanghai, China.
A representative sample of patients (n = 1478) and caregivers (n = 1478) was randomly obtained through a multi-stage cluster sampling in Shanghai, China. Reliability and validity tests were used to verify the psychometric properties of the instrument. The two-level random intercept model was applied to determine the factors of the caregiver burden between the household and the community level.
Cronbach's alpha coefficient was 0.90 for the overall instrument with statistical significance. Factor analysis suggested a three-factor model for the FBIS and confirmed that the adjusted unidimensional model and the second-order multidimensional model had better fit statistics. The average score of the caregiver burden in Shanghai was 12.62 ± 10.74, and financial burden constituted the major effect. The two-level random intercept model demonstrated that the risk factors were hospitalisation (β 1.69, 95%CI 0.48 to 2.90), elevated serum alanine aminotransferase levels (β 1.05, 95%CI 0.15 to 1.95), HCV infection (β 4.49, 95%CI 1.22 to 7.77), and acceptance of the hepatitis B vaccine (β 2.20, 95%CI 0.56 to 3.85), whereas the protective factors were no consumption of alcohol (β -2.69, 95%CI -5.19 to -0.19), average monthly costs for patients less than or equal to 100 US dollars (β -2.96, 95%CI -5.83 to -0.09), and good health status of family caregivers (β -9.91, 95%CI -12.76 to -7.05).
FBIS can accurately measure the caregiver burden for chronic hepatitis. Targeting interventions toward the conditions associated with the caregiver burden is of great importance.
在中国，慢性病毒性肝炎患者的照料者承受着相当大的负担、压力，自身幸福感和社会活动受到影响。对照料者影响的测量是一个研究不足的领域。家庭负担访谈量表（FBIS）最初是为精神分裂症患者的照料者设计的，该疾病的不良影响与慢性病毒性肝炎对家庭照料者的影响相似。在本研究中，我们前瞻性地评估了FBIS在慢性病毒性肝炎领域的心理测量特性，并使用它来确定影响中国上海慢性病毒性肝炎患者家庭成员照料者负担的因素。
通过在中国上海进行的多阶段整群抽样，随机选取了具有代表性的患者样本（n = 1478）和照料者样本（n = 1478）。使用信效度测试来验证该工具的心理测量特性。应用二级随机截距模型来确定家庭和社区层面照料者负担的因素。
整个量表的Cronbach's alpha系数为0.90，具有统计学意义。因子分析表明FBIS存在一个三因子模型，并证实调整后的单维模型和二阶多维模型具有更好的拟合统计量。上海照料者负担的平均得分为12.62±10.74，经济负担是主要影响因素。二级随机截距模型表明，危险因素为住院（β 1.69，95%CI 0.48至2.90）、血清丙氨酸氨基转移酶水平升高（β 1.05，95%CI 0.15至1.95）、丙型肝炎病毒感染（β 4.49，95%CI 1.22至7.77）以及接种乙肝疫苗（β 2.20，95%CI 0.56至3.85），而保护因素为不饮酒（β -2.69，95%CI -5.19至-0.19）、患者平均每月费用小于或等于100美元（β -2.96，95%CI -5.83至-0.09）以及家庭照料者健康状况良好（β -9.91，95%CI -12.76至-7.05）。
FBIS能够准确测量慢性肝炎患者照料者的负担。针对与照料者负担相关的状况进行干预非常重要。
