Burke Tom, Galvin Miriam, Pinto-Grau Marta, Lonergan Katie, Madden Caoifa, Mays Iain, Carney Sile, Hardiman Orla, Pender Niall
Department of Psychology, Lower Ground Floor, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Dublin 2, Ireland.
J Neurol. 2017 May;264(5):898-904. doi: 10.1007/s00415-017-8448-5. Epub 2017 Mar 9.
Few studies in amyotrophic lateral sclerosis (ALS) have profiled disease-specific features of the condition in conjunction with assessment of caregivers' burden, distress, quality of life, and investigated patient survival. Eighty-four ALS patients and their primary caregivers were enrolled. Patients completed ALS-specific measures of physical and cognitive function, while caregivers completed measures of anxiety, depression, caregiver burden, and quality of life. Patient-caregiver dyads were interviewed about their health-service utilisation. Survival data were obtained through the Irish register for ALS. Participants were dichotomised into low/high groups according to the severity of self-reported caregiver burden, based on statistically derived cut-off scores. High-burdened caregivers (n = 43) did not significantly differ from low-burdened caregivers (n = 41) with respect to disease-specific characteristics, i.e., ALSFRS-R, bulbar- or spinal-onset ALS, disease duration, or survival data. However, significant differences were reported on subjective measures of anxiety (p < 0.000), depression (p < 0.001), distress (p < 0.000), and quality of life (p < 0.000). These data demonstrate the limited impact of ALS patient-related variables, i.e., ALSFRS-R and onset, on caregiver burden in ALS, and identify the importance of the psychological composition of caregivers. This study suggests that the subjective experience of individual caregivers is an important factor influencing the severity of experienced caregiver burden.
在肌萎缩侧索硬化症(ALS)领域,很少有研究将该疾病的特定特征与对护理人员负担、痛苦、生活质量的评估相结合,并对患者的生存率进行调查。招募了84名ALS患者及其主要护理人员。患者完成了针对ALS的身体和认知功能测量,而护理人员完成了焦虑、抑郁、护理负担和生活质量的测量。对患者 - 护理人员二元组进行了关于其医疗服务利用情况的访谈。通过爱尔兰ALS登记册获取生存数据。根据统计得出的临界分数,参与者根据自我报告的护理人员负担严重程度被分为低/高两组。高负担护理人员(n = 43)与低负担护理人员(n = 41)在疾病特定特征方面,即ALS功能评定量表修订版(ALSFRS-R)、延髓或脊髓起病的ALS、疾病持续时间或生存数据方面,没有显著差异。然而,在焦虑(p < 0.000)、抑郁(p < 0.001)、痛苦(p < 0.000)和生活质量(p < 0.000)的主观测量方面报告了显著差异。这些数据表明,ALS患者相关变量,即ALSFRS-R和起病情况,对ALS护理人员负担的影响有限,并确定了护理人员心理构成的重要性。这项研究表明,个体护理人员的主观体验是影响所经历的护理人员负担严重程度的一个重要因素。