中风后两年内，是什么让家庭护理人员感到幸福？

What makes family caregivers happy during the first 2 years post stroke?

作者信息

Cameron Jill I, Stewart Donna E, Streiner David L, Coyte Peter C, Cheung Angela M

机构信息

From the Departments of Occupational Science and Occupational Therapy (J.I.C.), Psychiatry (D.E.S., D.L.S.), Institute of Health Policy, Management, and Evaluation (P.C.C.), and Department of General Internal Medicine (A.M.C.), University of Toronto, ON, Canada; Toronto Rehabilitation Institute (J.I.C.), University Health Network (D.E.S., A.M.C.), Toronto, ON, Canada; and Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada (D.L.S.).

出版信息

Stroke. 2014 Apr;45(4):1084-9. doi: 10.1161/STROKEAHA.113.004309. Epub 2014 Mar 20.

DOI:10.1161/STROKEAHA.113.004309

PMID:24652310

Abstract

BACKGROUND AND PURPOSE

This study aimed to identify aspects of the caregiving situation contributing to family caregivers' psychological well-being.

METHODS

Longitudinal cohort study with structured quantitative interviews 1, 3, 6, and 12 months post stroke. A subset of participants also completed surveys 18 and 24 months post stroke. Participants included individuals hospitalized for their first stroke and their family caregivers. Psychological well-being was assessed by the Positive Affect Scale.

RESULTS

A total of 399 stroke survivor, caregiver dyads completed the 1-year follow-up and 80 dyads completed the second year of follow-up. Using mixed effects modeling for longitudinal data, caregivers reported more psychological well-being when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities had more mastery, gained personally providing care, were in better physical health, were older, and were from Quebec reported more psychological well-being. Caregivers followed for a second year post stroke reported better psychological well-being when caring for stroke survivors with fewer symptoms of depression and more severe strokes and when the caregivers had a greater sense of mastery and gained more personally providing care.

CONCLUSIONS

Our findings contribute to the caregiver intervention development literature by identifying aspects of the caregiving situation that are associated with positive outcomes. Incorporating specific aspects, for example, strategies to enhance caregiver mastery into programs and services offered to caregivers may enhance their positive experiences with providing care and ultimately enhance the sustainability of the caregiving situation.

摘要

背景与目的

本研究旨在确定有助于家庭照顾者心理健康的照顾情境因素。

方法

纵向队列研究，在中风后1、3、6和12个月进行结构化定量访谈。部分参与者还在中风后18和24个月完成了调查。参与者包括首次因中风住院的个体及其家庭照顾者。通过积极情感量表评估心理健康状况。

结果

共有399对中风幸存者与照顾者完成了1年随访，80对完成了第2年随访。使用纵向数据的混合效应模型，当照顾者为抑郁症状较少、认知功能较好且中风更严重的中风幸存者提供更多帮助时，他们报告的心理健康状况更好。此外，持续参与有价值活动的照顾者有更强的掌控感，在个人护理方面有所收获，身体健康状况更好，年龄较大，且来自魁北克的照顾者报告的心理健康状况更好。中风后第2年接受随访的照顾者，在照顾抑郁症状较少且中风更严重的幸存者时，以及当照顾者有更强的掌控感且在个人护理方面收获更多时，报告的心理健康状况更好。