Watanabe Aki, Fukuda Michinari, Suzuki Makoto, Kawaguchi Takayuki, Habata Toshiya, Akutsu Tsugio, Kanda Tadashi
Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
Faculty of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.
J Stroke Cerebrovasc Dis. 2015 Feb;24(2):424-30. doi: 10.1016/j.jstrokecerebrovasdis.2014.09.013. Epub 2014 Dec 12.
This study attempted to assess continued long-term home care by examining patients' independent activities of daily living (ADLs) and caregivers' free time.
We surveyed the main caregivers of 52 patients with cerebrovascular disease with continuous home care from 1999 to 2010. Survey items were patients' ADLs, the frequency of use of care services, care requirements, and caregiver sense of burden. We compared the survey results between years.
ADLs of excretory control, verbal expression, verbal comprehension, and range of activities showed significant deterioration from 1999 to 2010. Patient need for care increased significantly but use of care services did not. Main caregivers were typically spouses who aged together with the patients. Main caregivers rarely changed; occasionally, a son or daughter-in-law became the main caregiver. Patients typically required less than 3 hours of care daily, which did not change over time. Caregivers had significantly more difficulty maintaining their own health in 2010 than 1999. However, they did not identify increases in difficulties with housework or coping with work. They felt that caregiving was a burden but did not indicate that the family relationship had deteriorated.
Regardless of degree of independence of patients' ADLs, caregiver burden was severe. To decrease caregiver burden, it is necessary to use care services, reduce care time, and allow caregivers free time. In addition, it is possible to continue long-term home care by maintaining their relationships.
本研究试图通过检查患者的日常生活自理活动(ADL)和照顾者的空闲时间来评估长期家庭护理情况。
我们对1999年至2010年期间接受持续家庭护理的52例脑血管疾病患者的主要照顾者进行了调查。调查项目包括患者的ADL、护理服务使用频率、护理需求以及照顾者的负担感。我们比较了不同年份的调查结果。
1999年至2010年期间,排泄控制、言语表达、言语理解及活动范围等ADL出现显著恶化。患者的护理需求显著增加,但护理服务的使用并未增加。主要照顾者通常是与患者一同变老的配偶。主要照顾者很少更换;偶尔,儿子或儿媳会成为主要照顾者。患者通常每天需要不到3小时的护理,且这一情况未随时间变化。与1999年相比,2010年照顾者在维持自身健康方面困难显著增加。然而,他们并未发现家务或工作应对方面的困难有所增加。他们觉得照顾是一种负担,但并未表明家庭关系恶化。
无论患者ADL的独立程度如何,照顾者负担都很重。为减轻照顾者负担,有必要使用护理服务、减少护理时间并给予照顾者空闲时间。此外,通过维持他们的关系可以继续长期家庭护理。