Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK.
Br J Psychiatry. 2014 Sep;205(3):197-203. doi: 10.1192/bjp.bp.112.125369. Epub 2014 Jul 24.
Caregivers make a significant and growing contribution to the social and medical care of people with long-standing disorders. The effective provision of this care is dependent on their own continuing health.
To investigate the relationship between weekly time spent caregiving and psychiatric and physical morbidity in a representative sample of the population of England.
Primary outcome measures were obtained from the Adult Psychiatric Morbidity Survey 2007. Self-report measures of mental and physical health were used, along with total symptom scores for common mental disorder derived from the Clinical Interview Schedule-Revised.
In total, 25% (n = 1883) of the sample identified themselves as caregivers. They had poorer mental health and higher psychiatric symptom scores than non-caregivers. There was an observable decline in mental health above 10 h per week. A twofold increase in psychiatric symptom scores in the clinical range was recorded in those providing care for more than 20 h per week. In adjusted analyses, there was no excess of physical disorders in caregivers.
We found strong evidence that caregiving affects the mental health of caregivers. Distress frequently reaches clinical thresholds, particularly in those providing most care. Strategies for maintaining the mental health of caregivers are needed, particularly as demographic changes are set to increase involvement in caregiving roles.
护理人员对长期患病者的社会和医疗护理做出了重大且日益增长的贡献。这种护理的有效提供取决于他们自身的持续健康。
在英格兰人口的代表性样本中,调查每周护理时间与精神和身体发病率之间的关系。
主要结果指标来自 2007 年成人精神疾病发病率调查。使用心理健康和身体健康的自我报告衡量标准,以及从临床访谈时间表修订版得出的常见精神障碍的总症状得分。
共有 25%(n = 1883)的样本将自己确定为护理人员。他们的心理健康状况较差,精神症状评分较高。每周护理时间超过 10 小时,心理健康状况明显下降。每周提供超过 20 小时护理的人,其精神症状评分达到临床范围的两倍增加。在调整分析中,护理人员并没有出现过多的身体疾病。
我们发现有强有力的证据表明护理会影响护理人员的心理健康。护理人员经常会感到痛苦,尤其是那些提供大部分护理的人。需要制定策略来维护护理人员的心理健康,特别是随着人口结构的变化,参与护理角色的人数将会增加。