Pooyania Sepideh, Lobchuk Michelle, Chernomas Wanda, Marrie Ruth Ann
Department of Internal Medicine (SP, RAM) and Department of Community Health Sciences (RAM), College of Medicine; and College of Nursing (ML, WC), Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Int J MS Care. 2016 May-Jun;18(3):122-8. doi: 10.7224/1537-2073.2015-023.
Multiple sclerosis (MS) is the most common nontraumatic cause of disability affecting young adults in Canada. Caregivers of patients with MS are highly psychologically burdened. Empathy and helping behaviors are hallmarks of quality care, but when they are challenged, suboptimal patient care can result. We aimed to evaluate the prevalence of negative emotional states among primary caregivers of people with MS; the association between the caregiver's empathy-related behavior and the physical and cognitive impairment of the person with MS; and the association between the caregiver's emotional status and his or her empathy-related behaviors.
We conducted a descriptive, cross-sectional pilot study with family caregivers of noninstitutionalized individuals living with MS. We used univariate linear regression models for each potential predictor. The Kruskal-Wallis test was conducted to compare differences in caregiver empathic responses depending on Profile of Mood States subscale scores.
Thirty percent of caregivers had elevated or very elevated mood scores, and such elevated scores were associated with greater functional impact of MS on the person with MS. Patient severity of cognitive impairment was not associated with caregiver mood scores. Caregiver mood state was not associated with empathy-related behaviors. Empathy-related behaviors were less frequent when levels of anger and hostility were higher, but this association did not reach statistical significance.
Given the elevated levels of fatigue, depression, and anger observed among caregivers in this study, clinicians need to be aware of the potential impact of caregiving and to assess the needs of caregivers.
多发性硬化症(MS)是加拿大影响年轻人的最常见非创伤性致残原因。MS患者的照顾者心理负担很重。同理心和帮助行为是优质护理的标志,但当这些受到挑战时,可能会导致患者护理效果不佳。我们旨在评估MS患者主要照顾者中负面情绪状态的患病率;照顾者与同理心相关的行为与MS患者身体和认知障碍之间的关联;以及照顾者的情绪状态与其与同理心相关行为之间的关联。
我们对非机构化MS患者的家庭照顾者进行了一项描述性横断面试点研究。我们对每个潜在预测因素使用单变量线性回归模型。进行Kruskal-Wallis检验以比较根据情绪状态量表子量表得分的照顾者同理心反应差异。
30%的照顾者情绪得分升高或非常高,且此类升高的得分与MS对患者的功能影响更大相关。患者认知障碍的严重程度与照顾者情绪得分无关。照顾者情绪状态与同理心相关行为无关。当愤怒和敌意水平较高时,与同理心相关的行为较少见,但这种关联未达到统计学意义。
鉴于本研究中观察到照顾者疲劳、抑郁和愤怒水平升高,临床医生需要意识到照顾的潜在影响并评估照顾者的需求。