Liu Hsin-Yun, Yang Ching-Tzu, Cheng Huey-Shinn, Wu Chi-Chuan, Chen Ching-Yen, Shyu Yea-Ing L
Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Psychosom Res. 2015 May;78(5):452-458. doi: 10.1016/j.jpsychores.2015.02.002. Epub 2015 Feb 15.
This study investigated the relationship between family caregivers' mental health and postoperative recovery for elderly patients with hip fracture in Taiwan.
This study is a secondary analysis of data from a randomized controlled trial with 12-month follow-up on 276 family caregiver-patient dyads. Categories of caregiver mental-health trajectory groups were identified by latent-class finite-mixture modeling. Differences in these groups were explored using the generalized estimating equation approach for effects on patients' postoperative recovery, including pain intensity, range of motion, maximum muscle strength, recovery of self-care ability, mobility, re-hospitalization, and health-related quality of life.
The patterns of family caregivers' mental health best fit a three-group trajectory model (poor, moderate, and good). Compared to patients with caregivers in the "poor" mental health group, patients with caregivers in the "good" group had better trajectories in physical functional recovery, including mobility, muscle strength, hip flexion and extension, and ankle extension. These patients were also less likely to be hospitalized, experienced less pain, and had better physical and mental health. Patients with caregivers in the "moderate" group likewise performed better than those in the "poor" group.
During the first year following discharge, postoperative recovery of patients after hip fracture was associated with their family caregivers' mental health. When a family caregiver's mental health was "poor," the patient recovering after hip-fracture surgery was more likely to recover poorly. These results suggest that health care providers could consider family caregivers' mental well-being while estimating recovery times and health outcomes of patients following hip fracture.
本研究调查了台湾地区老年髋部骨折患者的家庭照顾者心理健康与术后恢复之间的关系。
本研究是对一项随机对照试验的数据进行二次分析,该试验对276对家庭照顾者-患者二元组进行了为期12个月的随访。通过潜在类别有限混合模型确定照顾者心理健康轨迹组的类别。使用广义估计方程方法探讨这些组之间的差异,以了解对患者术后恢复的影响,包括疼痛强度、活动范围、最大肌肉力量、自我护理能力恢复、活动能力、再次住院情况以及与健康相关的生活质量。
家庭照顾者的心理健康模式最符合三组轨迹模型(差、中、好)。与“差”心理健康组的照顾者所照顾的患者相比,“好”组照顾者所照顾的患者在身体功能恢复方面有更好的轨迹,包括活动能力、肌肉力量、髋关节屈伸和踝关节伸展。这些患者也不太可能住院,经历的疼痛更少,身心健康状况更好。“中”组照顾者所照顾的患者同样比“差”组的患者表现更好。
在出院后的第一年,髋部骨折患者的术后恢复与他们家庭照顾者的心理健康有关。当家庭照顾者的心理健康“差”时,髋部骨折手术后康复的患者更有可能恢复不佳。这些结果表明,医疗保健提供者在估计髋部骨折患者的恢复时间和健康结果时,可以考虑家庭照顾者的心理健康状况。