Mougias A A, Politis A, Mougias M A, Kotrotsou I, Skapinakis P, Damigos D, Mavreas V G
Alzheimer Center of the Greek Psychogeriatric Association "Nestor", Athens.
Department of Psychiatry, Eginition Hospital, School of Medicine, University of Athens, Athens.
Psychiatriki. 2015 Jan-Mar;26(1):28-37.
Dementia not only affects patients but also care providers. The assessment of Caregivers' Burden (CB) has grown exponentially in the dementia field, as studies have shown that it is higher in dementia than in other diseases. Dementia care in Greece is different compared to other developed countries, as most of the patients receive care at home from family members. The aim of the present study was to examine the level of burden in Greek caregivers who live in Athens, and its association with patient and caregiver factors. This was a cross-sectional study of 161 primary caregivers of dementia patients living in the community and attending a secondary clinic. CB was assessed with the Zarit Burden Interview (ZBI) and caregivers' depression with the Center for Epidemiological Studies Depression Scale (CES-D). Clinical characteristics of the patients were also assessed using validated scales (cognitive status, functional ability, neuropsychiatric symptoms). In order to find predictors of caregiver Burden, we conducted a 3-step hierarchical regression analysis. Most patients were suffering from Alzheimer's Dementia (n=101; 62.73%) and had moderate and severe dementia according to the MMSE score (mean MMSE=11.50), with patients being unable to perform 2 basic activities of daily living on average. 45 patients (27.95%) had depression according to the CSDD; only 5 patients didn't have any behavioral problem in the NPI, while patients had more than 5 behavioral problems on average. Caregivers were involved in their role for 3.6 years on average and the mean weekly caregiving time was more than 70 hours. Nearly half (n=80; 49.06%) of the 161 caregivers demonstrated high CB (ZBI>40) and nearly one fourth had depression according to the CES-D scale. All blocks of variables entered into the regression model independently predicted caregiver burden's variance (demographics, clinical factors and caregiving characteristics). Lower caregiver's age, high behavioral symptoms of dementia patients and caregivers' depression were found to be independently associated with CB. The final regression model explained 47.2% of the variance in CB. Dementia causes a great burden in caregivers. CB is a complex issue that is associated with several patients and caregivers' factors. The level of CB should be assessed in everyday dementia clinical practice.
痴呆症不仅影响患者，也影响护理人员。在痴呆症领域，对护理人员负担（CB）的评估呈指数级增长，因为研究表明，痴呆症患者的护理人员负担比其他疾病患者的护理人员负担更重。与其他发达国家相比，希腊的痴呆症护理情况有所不同，因为大多数患者在家中接受家庭成员的护理。本研究的目的是调查居住在雅典的希腊护理人员的负担水平，以及它与患者和护理人员因素之间的关联。这是一项对161名居住在社区且在二级诊所就诊的痴呆症患者的主要护理人员进行的横断面研究。使用 Zarit 负担访谈量表（ZBI）评估护理人员负担，使用流行病学研究中心抑郁量表（CES-D）评估护理人员的抑郁情况。还使用经过验证的量表（认知状态、功能能力、神经精神症状）评估患者的临床特征。为了找出护理人员负担的预测因素，我们进行了三步分层回归分析。大多数患者患有阿尔茨海默病痴呆症（n = 101；62.73%），根据简易精神状态检查表（MMSE）评分，患有中度和重度痴呆症（平均 MMSE = 11.50），患者平均无法进行两项日常生活基本活动。根据临床痴呆评定量表（CSDD），45名患者（27.95%）患有抑郁症；在神经精神症状量表（NPI）中，只有5名患者没有任何行为问题，而患者平均有超过5个行为问题。护理人员平均担任护理角色3.6年，平均每周护理时间超过70小时。在161名护理人员中，近一半（n = 80；49.06%）表现出高护理人员负担（ZBI > 40），根据CES-D量表，近四分之一的护理人员患有抑郁症。纳入回归模型的所有变量组均独立预测了护理人员负担的方差（人口统计学、临床因素和护理特征）。护理人员年龄较小、痴呆症患者的高行为症状以及护理人员的抑郁被发现与护理人员负担独立相关。最终回归模型解释了护理人员负担方差的47.2%。痴呆症给护理人员带来了巨大负担。护理人员负担是一个复杂的问题，与多个患者和护理人员因素相关。在日常痴呆症临床实践中应评估护理人员负担水平。
