Grover Sandeep, Chakrabarti Subho, Ghormode Deepak, Dutt Alakananda
a Sandeep Grover, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
b Subho Chakrabarti, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
Nord J Psychiatry. 2015;69(8):629-36. doi: 10.3109/08039488.2015.1033010. Epub 2015 Apr 30.
Although many studies in schizophrenia have evaluated health-care needs, there is a lack of data on the needs of patients with bipolar affective disorder (BPAD), with only occasional studies evaluating them, and no study has evaluated the relationship of health-care needs of patients with caregiver's burden.
To study the relationship of caregiver's burden and needs of patients as perceived by caregivers of patients with BPAD and schizophrenia.
Caregivers of patients with BPAD and schizophrenia were assessed using the Camberwell Assessment of Needs - Research version (CAN-R) and Supplementary Needs Assessment Scale (SNAS), the Family Burden Interview schedule (FBI) and the Involvement Evaluation Questionnaire (IEQ).
Mean total needs of patients on CAN-R were 7.54 (SD 3.59) and 7.58 (SD 4.24) for BPAD and schizophrenia respectively. Mean total needs for SNAS were 7.24 (SD 3.67) and 7.68 (SD 5.02) for BPAD and schizophrenia groups, respectively. Total objective and subjective burden as assessed on FBI was significantly more for the schizophrenia group. Caregivers of patients with BPAD perceived significantly less disruption of routine family activities and lower impact on the mental health of others. On IEQ, the mean score on the domain of supervision was significantly higher for the BPAD group. In the schizophrenia group, positive correlations were seen between the total number of unmet and total (met and unmet) needs and certain aspects of burden, but no such correlations emerged in the BPAD group.
There is no correlation between number of needs and burden in the BPAD group; however, in the schizophrenia group the number of needs correlated with the perceived burden. Accordingly, orienting services to address needs of patients with schizophrenia can lead to reduction in burden among caregivers.
尽管许多关于精神分裂症的研究评估了医疗保健需求,但双相情感障碍(BPAD)患者需求的数据却很缺乏,仅有偶尔的研究对其进行评估,且尚无研究评估患者医疗保健需求与照顾者负担之间的关系。
研究BPAD和精神分裂症患者的照顾者所感知到的照顾者负担与患者需求之间的关系。
使用坎伯韦尔需求评估研究版(CAN-R)、补充需求评估量表(SNAS)、家庭负担访谈表(FBI)和参与度评估问卷(IEQ)对BPAD和精神分裂症患者的照顾者进行评估。
BPAD和精神分裂症患者在CAN-R上的平均总需求分别为7.54(标准差3.59)和7.58(标准差4.24)。BPAD组和精神分裂症组在SNAS上的平均总需求分别为7.24(标准差3.67)和7.68(标准差5.02)。在FBI上评估的精神分裂症组的客观和主观总负担明显更重。BPAD患者的照顾者认为日常家庭活动受到的干扰明显更少,对他人心理健康的影响也更低。在IEQ上,BPAD组在监督领域的平均得分明显更高。在精神分裂症组中,未满足需求总数与总需求(满足和未满足需求)总数与负担的某些方面呈正相关,但在BPAD组中未出现此类相关性。
BPAD组需求数量与负担之间无相关性;然而,在精神分裂症组中,需求数量与感知到的负担相关。因此,针对精神分裂症患者需求提供服务可减轻照顾者的负担。