Heggie Marcie, Morgan Debra, Crossley Margaret, Kirk Andrew, Wong Patrick, Karunanayake Chandima, Beever Rob
Medical Student (2011), University of Saskatchewan, TEL: (306) 280-4697.
Professor, Canadian Centre for Health & Safety in Agriculture 1 , Chair, Rural Health Delivery, TEL: (306) 966-7905, FAX: (306) 966-8799.
Dementia (London). 2012 Jul 9;11(4):521-541. doi: 10.1177/1471301211421085.
This study examined change in patient and caregiver ratings of patient quality of life (QOL) over one year in individuals with dementia living in rural and remote settings. The sample was selected from non-institutionalized patients who were assessed at an interprofessional memory clinic. Measures of QOL, cognitive function, depression, and functional ability were completed by the patient. Caregivers completed measures of patient QOL and behavior, and their own burden and distress. At baseline (clinic day) 119 patients and family caregivers were assessed. Thirty-two families had complete data at clinic day and one-year follow-up. There was no significant change in either patient or caregiver-rated QOL over one year. Significant predictors of patient self-rated QOL were patient symptoms of depressed mood and functional ability at clinic day, and symptoms of depressed mood and clinic day QOL at one year. Significant predictors of caregiver-rated patient QOL were caregiver burden, patient functional ability, and symptom severity at clinic day, and caregiver burden at one year. Patient and caregiver ratings of patient QOL were moderately associated, but neither patients nor their caregivers reported a significant change in patient QOL. Changes in QOL over time remain a unique individual experience that cannot be entirely predicted by analytical models.
本研究调查了居住在农村和偏远地区的痴呆症患者及其照料者对患者生活质量(QOL)的评分在一年中的变化情况。样本选自在跨专业记忆诊所接受评估的非机构化患者。患者完成了生活质量、认知功能、抑郁和功能能力的测量。照料者完成了患者生活质量和行为的测量,以及他们自己的负担和痛苦程度的测量。在基线(诊所就诊日)时,对119名患者及其家庭照料者进行了评估。32个家庭在诊所就诊日和一年随访时有完整的数据。患者或照料者评定的生活质量在一年中均无显著变化。患者自评生活质量的显著预测因素是就诊日的抑郁情绪症状和功能能力,以及一年时的抑郁情绪症状和就诊日生活质量。照料者评定的患者生活质量的显著预测因素是照料者负担、患者功能能力、就诊日的症状严重程度,以及一年时的照料者负担。患者和照料者对患者生活质量的评分存在中度相关性,但患者及其照料者均未报告患者生活质量有显著变化。生活质量随时间的变化仍然是一种独特的个体体验,无法完全通过分析模型预测。