Nakken Nienke, Spruit Martijn A, Wouters Emiel F M, Schols Jos M G A, Janssen Daisy J A
Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands.
Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands.
Scand J Caring Sci. 2015 Dec;29(4):734-44. doi: 10.1111/scs.12204. Epub 2015 Feb 4.
Family caregivers already have a paramount role in daily care for patients with chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), or chronic renal failure (CRF). To date, it remains unknown whether and to what extent the experience of caregiving changes over time.
To examine changes in caregiver burden and positive aspects of caregiving during 1-year follow-up in patients with advanced COPD, CHF or CRF and to study determinants of changes in caregiver burden and positive aspects of caregiving.
In this longitudinal observational study, patients and their family caregivers who had complete data at baseline and 12 months (n = 104) and family caregivers of patients who died during 1-year follow-up (n = 15) were included. Caregiver burden and positive aspects of caregiving were assessed using the Family Appraisal of Caregiving Questionnaire for Palliative Care (FACQ-PC). Domain scores were classified into three categories, and baseline characteristics were compared between these categories.
A majority of the individuals showed 1-year changes in FACQ-PC domain scores. These individual changes were not explained by demographic or clinical patient characteristics at baseline or changes in patient characteristics during 1-year follow-up. Furthermore, caregiver burden was higher for caregivers of patients who died during 1-year follow-up compared to caregivers whose relative completed 1-year follow-up.
This study showed that caregiver burden and positive aspects of caregiving can change over time, and these changes are highly individual. Therefore, healthcare providers should regularly pay attention to family caregivers, regardless the patients' characteristics.
家庭照顾者在慢性阻塞性肺疾病(COPD)、慢性心力衰竭(CHF)或慢性肾衰竭(CRF)患者的日常护理中已发挥着至关重要的作用。迄今为止,照顾经历是否以及在何种程度上会随时间变化仍不明确。
研究晚期COPD、CHF或CRF患者在1年随访期间照顾者负担及照顾积极方面的变化,并探讨照顾者负担及照顾积极方面变化的决定因素。
在这项纵向观察性研究中,纳入了在基线和12个月时拥有完整数据的患者及其家庭照顾者(n = 104)以及在1年随访期间死亡患者的家庭照顾者(n = 15)。使用姑息治疗照顾者家庭评估问卷(FACQ-PC)评估照顾者负担及照顾积极方面。领域得分分为三类,并比较这些类别之间的基线特征。
大多数个体的FACQ-PC领域得分在1年内发生了变化。这些个体变化无法通过基线时的人口统计学或临床患者特征或1年随访期间患者特征的变化来解释。此外,与亲属完成1年随访的照顾者相比,1年随访期间死亡患者的照顾者负担更高。
本研究表明,照顾者负担及照顾积极方面会随时间变化,且这些变化具有高度个体性。因此,医疗保健提供者应定期关注家庭照顾者,而不论患者的特征如何。