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在阿尔茨海默病背景下,亲属关系和同居与照料者负担的关系:一项 24 个月的纵向研究。

Kinship and cohabitation in relation to caregiver burden in the context of Alzheimer's disease: a 24-month longitudinal study.

机构信息

Dementia Unit, Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain.

Health, Aging and Disability Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.

出版信息

Int J Geriatr Psychiatry. 2017 Dec;32(12):e72-e82. doi: 10.1002/gps.4656. Epub 2017 Jan 23.

Abstract

OBJECTIVES

The aims of the study were to identify the clinical characteristics of three groups of caregivers: spouses, live-in adult-child or non-live-in adult-child, and their relation to the degree of perceived burden (Caregiver Burden Interview).

METHODS

The sample comprised 275 Alzheimer's disease primary caregivers, with a follow-up of 24 months. Cognitive, functional and behavioural characteristics were evaluated in persons with dementia, whilst sociodemographic data, use of socio-medical resources, physical and mental health and self-perceived burden were assessed in caregivers. Generalized estimating equations were used for longitudinal data analysis.

RESULTS

Spouse caregivers were 45.0% men, sole caregivers (>80%), used few external resources and had worse physical health. The number of female adult-child caregivers was higher (>75%). The live-in adult-child group, compared with the non-live-in adult-child group, was less likely to be married, had a lower level of education, was more commonly the sole caregiver and used fewer external resources. The greatest burden was observed in live-in adult-child caregivers, and the lowest in the non-live-in adult-child group, with no significant variation in the follow-up for both groups. Spouses had an intermediate level of perceived burden, which rose significantly during follow-up (p < 0.001).

CONCLUSIONS

Kinship and cohabitation with the persons with dementia were associated with different scores and evolution of the burden, with an increase in the follow-up of the spouses, and with more or less burden, depending on cohabitation, in the adult-child groups. Interventions to reduce the level of burden on caregivers should consider these differences. Copyright © 2017 John Wiley & Sons, Ltd.

摘要

目的

本研究旨在识别三组照料者的临床特征:配偶、同住成年子女或非同住成年子女,以及他们与感知负担程度的关系(照料者负担访谈)。

方法

该样本包括 275 名阿尔茨海默病的主要照料者,随访时间为 24 个月。对痴呆患者进行认知、功能和行为特征评估,同时对照料者进行社会人口学数据、社会医疗资源使用、身心健康和自我感知负担评估。采用广义估计方程进行纵向数据分析。

结果

配偶照料者中男性占 45.0%,他们是主要照料者(>80%),使用的外部资源较少,身体健康状况较差。女性成年子女照料者的数量较多(>75%)。与非同住成年子女组相比,同住成年子女组更不可能已婚,教育程度较低,更可能是唯一的照料者,使用的外部资源较少。同住成年子女照料者的负担最大,非同住成年子女组的负担最小,两组在随访过程中均无显著变化。配偶的感知负担处于中等水平,但在随访过程中显著增加(p<0.001)。

结论

与痴呆患者的亲属关系和共同居住与负担的不同评分和演变相关,随着配偶随访时间的延长,负担显著增加(p<0.001),而在成年子女组中,共同居住会增加或减轻负担,这取决于是否共同居住。减轻照料者负担的干预措施应考虑这些差异。

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