Le Priol Laure, Chambelland Didier, Connan Laurent, Etcharry-Bouyx Frédérique, Huez Jean François
Département de médecine générale, Université d'Angers, France.
Service de neurologie, CHU Angers, France.
Geriatr Psychol Neuropsychiatr Vieil. 2014 Jun;12(2):155-62. doi: 10.1684/pnv.2014.0475.
The caregivers of patients with Alzheimer's disease (AD) play a key role in their management. Half of them are spouses. This involvement may alter their own health, leading to exhaustion and depression. Since 2010, general practitioners (GPs) have been invited in France to offer an annual specific medical support to spouse caregivers. The aims of this study were to understand their experience of this situation by spouse caregivers, and how the spouse caregiver perceives the role of the GP in this context.
A qualitative approach was conducted using semi-structured interviews of 14 spouse caregivers recruited from adult day care in Angers, France.
The analysis of interviews showed that AD was an existential crisis for the dyad AD patient/spouse caregiver. The emotional connection and the sense of commitment strongly involved the spouse caregivers into cares for the loved ones. Even if the frequency of medical consultations remained unchanged, caregivers were more prone to delay non-urgent cares for themselves. Moreover their intention to handle things on their own and the interaction with health professionals of the care recipients interfered with the involvement of the caregivers' GPs.
Caregivers' adaptation to their spouses' AD resulted in both negative and positive behaviors. Instead of a mandatory annual consultation focused on caregivers' health, the improvement of communication between all support services, including caregivers' GPs, may help to enhance the medical support of spouse caregivers of AD patients.
阿尔茨海默病（AD）患者的照料者在患者管理中起着关键作用。其中一半是配偶。这种参与可能会改变他们自身的健康状况，导致疲惫和抑郁。自2010年以来，法国邀请全科医生（GPs）每年为配偶照料者提供特定的医疗支持。本研究的目的是了解配偶照料者对这种情况的体验，以及配偶照料者如何看待全科医生在此背景下的作用。
采用定性研究方法，对从法国昂热成人日托中心招募的14名配偶照料者进行半结构式访谈。
访谈分析表明，AD对AD患者/配偶照料者这一配对来说是一场生存危机。情感联系和责任感使配偶照料者强烈地投入到对亲人的照料中。即使医疗咨询的频率保持不变，照料者也更倾向于推迟自己的非紧急治疗。此外，他们自己处理事情的意愿以及与受照料者的医疗专业人员的互动干扰了照料者的全科医生的参与。
照料者对配偶患AD的适应导致了消极和积极的行为。与其进行以照料者健康为重点的强制性年度咨询，改善包括照料者的全科医生在内的所有支持服务之间的沟通，可能有助于加强对AD患者配偶照料者的医疗支持。
