Rosalind Franklin University of Medicine and Science,North Chicago,Illinois.
University of Missouri,Columbia,Missouri.
Palliat Support Care. 2018 Apr;16(2):127-136. doi: 10.1017/S1478951516001152. Epub 2017 Jan 31.
ABSTRACTObjective:Researchers sought to determine the extent to which burden related to patients' symptom subtypes could predict informal hospice caregiver depression, and to illustrate the differences between caregivers who experience suicidal ideation and those who do not.
Informal caregivers recruited from a not-for-profit community-based hospice agency participated in a cross-sectional survey. Self-report questionnaires assessed caregiver burden associated with patient symptomatology (via a modified version of the Memorial Symptom Assessment Scale-Short Form) and caregiver depressive symptoms, including suicidal ideation (measured by the Patient Health Questionnaire-9). Multiple regressions evaluated the unique predictability of patients' symptom subtypes on caregiver depression. Exploratory analyses examined mean differences of study variables between participants who did and did not endorse suicidal ideation.
Caregiver burden related to patients' psychological symptoms accounted for significant variance in caregiver depression scores when controlling for burden related to physical symptoms. Among 229 caregivers (M age = 61.4 years), 12 reported suicidal ideation, where 6 of the 12 were male, despite male caregivers comprising less than 20% of the total sample.
Burden associated with patients' psychological symptoms uniquely contributed to caregiver depression, further highlighting the clinical utility and necessity for hospice providers to address the emotional needs of patients and their caregivers alike. Developing clinical procedures to identify and respond to such needs would not only behoove hospice agencies, but it would likely enhance the caregiving experience holistically, which might be particularly imperative for male caregivers.
摘要
研究人员旨在确定患者症状亚型相关负担在多大程度上可以预测非正式临终关怀护理人员的抑郁程度,并说明有自杀意念和没有自杀意念的护理人员之间的差异。
从非营利性社区临终关怀机构招募的非正式护理人员参与了横断面调查。自我报告问卷评估了与患者症状相关的护理人员负担(通过修改后的纪念症状评估量表-短表)和护理人员的抑郁症状,包括自杀意念(通过患者健康问卷-9 进行衡量)。多元回归评估了患者症状亚型对护理人员抑郁的独特预测能力。探索性分析检查了在有和没有自杀意念的参与者之间研究变量的平均差异。
在控制与身体症状相关的负担后,与患者心理症状相关的护理人员负担对护理人员抑郁评分有显著的差异。在 229 名护理人员(M 年龄=61.4 岁)中,有 12 名报告有自杀意念,其中 6 名是男性,尽管男性护理人员不到总样本的 20%。
与患者心理症状相关的负担对护理人员的抑郁有独特的贡献,这进一步强调了临终关怀提供者关注患者和护理人员的情感需求的临床实用性和必要性。制定识别和应对这些需求的临床程序不仅符合临终关怀机构的利益,而且可能会全面改善护理体验,这对于男性护理人员来说可能尤为重要。