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意识障碍患者照料者的负担:一项纵向研究。

Caregiver's burden in disorders of consciousness: a longitudinal study.

作者信息

Covelli V, Sattin D, Giovannetti A M, Scaratti C, Willems M, Leonardi M

机构信息

Department of Psychology, e-Campus University, Milan, Italy.

Neurology, Public Health and Disability Unit and Coma Research Centre - Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.

出版信息

Acta Neurol Scand. 2016 Nov;134(5):352-359. doi: 10.1111/ane.12550. Epub 2016 Jan 8.

Abstract

OBJECTIVES

To study the changes in the burden of informal caregivers of patients with disorders of consciousness (DOC) over time.

MATERIALS AND METHODS

Short Form-12, Family Strain Questionnaire, Beck Depression Inventory and Coping Orientations to Problem Experiences were administered.

RESULTS

Data collected on 216 informal caregivers of patients with DOC (59.6% females, mean age 53.4 ± 12.7 years old) were analysed at two time-points (mean distance is 2.7 years). Results of the national study revealed that caregivers' mental health improved (T0: M = 41.1, SD = 11.8; T1: M = 45.8, SD = 11.7), whereas the emotional burden (T0: M = 7.4, SD = 3.6; T1: M = 6.6, SD = 3.9) and the presence of depressive symptoms (T0: M = 14.3, SD = 9.3; T1: M = 11.7, SD = 10.2) as well as the need for information about the disease (T0: M = 2.7, SD = 1.2; T1: M = 2.2, SD = 1.4), thoughts of death (T0: M = 3.6, SD = 1.5; T1: M = 3.1, SD = 1.6) and the use of avoiding coping strategy (T0: M = 7.8, SD = 1.0; T1: M = 6.0, SD = 1.3) decreased at T1. Furthermore, depressive symptoms positively correlated with the emotional burden (0.580) and negatively with the mental health component of caregivers' self-perceived health condition (-0.473). Physical (-0.308) and mental health (-0.444) negatively correlated with emotional burden. Finally, the acute event and patients' health condition still have a deep impact on the economic situation of the family.

CONCLUSION

Although high level of burden was observed, it tends to decrease over time, except for financial burden. Hence, this study suggests the importance to plan strategies or targeted interventions in order to reduce the psychosocial and financial burden associated with caregiving.

摘要

目的

研究意识障碍(DOC)患者非正式照护者的负担随时间的变化。

材料与方法

采用简短健康调查量表-12、家庭压力问卷、贝克抑郁量表和问题应对取向量表进行评估。

结果

对216名DOC患者的非正式照护者(59.6%为女性,平均年龄53.4±12.7岁)在两个时间点(平均间隔2.7年)收集的数据进行了分析。全国性研究结果显示,照护者的心理健康状况有所改善(T0:M = 41.1,SD = 11.8;T1:M = 45.8,SD = 11.7),而情感负担(T0:M = 7.4,SD = 3.6;T1:M = 6.6,SD = 3.9)、抑郁症状的出现(T0:M = 14.3,SD = 9.3;T1:M = 11.7,SD = 10.2)以及对疾病信息的需求(T0:M = 2.7,SD = 1.2;T1:M = 2.2,SD = 1.4)、死亡念头(T0:M = 3.6,SD = 1.5;T1:M = 3.1,SD = 1.6)和回避应对策略的使用(T0:M = 7.8,SD = 1.0;T1:M = 6.0,SD = 1.3)在T1时均有所下降。此外,抑郁症状与情感负担呈正相关(0.580),与照护者自我感知健康状况的心理健康成分呈负相关(-0.473)。身体(-0.308)和心理健康(-0.444)与情感负担呈负相关。最后,急性事件和患者的健康状况仍然对家庭经济状况有深远影响。

结论

尽管观察到负担水平较高,但除经济负担外,负担往往会随时间减轻。因此,本研究表明制定策略或有针对性的干预措施以减轻与照护相关的心理社会和经济负担的重要性。

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