Jeyagurunathan Anitha, Sagayadevan Vathsala, Abdin Edimansyah, Zhang YunJue, Chang Sherilyn, Shafie Saleha, Rahman Restria Fauziana Abdul, Vaingankar Janhavi Ajit, Chong Siow Ann, Subramaniam Mythily
Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, 539747, Singapore.
Health Qual Life Outcomes. 2017 May 19;15(1):106. doi: 10.1186/s12955-017-0676-y.
This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia.
A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver's quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative's illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses.
The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50-64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50-64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms of depression whilst those who cared for their son/daughter were less likely to be associated with symptoms of depression. Primary caregivers who had lower education, were living with others, were single or divorced/separated, were unemployed and with higher FIS scores were associated with lower QOL domain scores. Those with symptoms of depression were significantly associated with low QOL across all four domains, whilst those with symptoms of anxiety were significantly associated with low QOL in the social relationships domain.
Psychological status of caregivers in the current study was associated with the various domains of QOL. In particular, caregivers' symptoms of depression were significantly associated with lower QOL across all four domains of QOL whereas symptoms of anxiety were associated with lower scores in the social relationships domain. The study suggests a need to provide caregivers with social support and psycho-education to improve the QOL as well as aid in developing healthy coping strategies.
本研究旨在探讨患有各种精神疾病(包括早期精神病、慢性精神分裂症、抑郁症、焦虑症和痴呆症)患者的主要照料者的心理状况和生活质量。
本研究招募了350名在三级精神病医院为亲属寻求治疗的主要照料者。获取了社会人口统计学数据,并使用世界卫生组织生活质量简表来评估照料者的生活质量(QOL)。使用广泛性焦虑障碍7项量表(GAD - 7)和患者健康问卷9项量表(PHQ - 9)评估主要照料者的心理状况。家庭访谈日程表(FIS)用于评估照料亲属的疾病所带来的社会问题、家庭成员间的人际紧张关系、工作相关问题和经济困难的影响。使用多元线性和逻辑回归分析来检验生活质量、PHQ - 9和GAD - 7的社会人口统计学和临床相关性。使用多元线性回归分析来检验生活质量领域与心理状况之间的关联。
主要照料者的平均年龄为49.7岁(标准差 = 13.2),年龄范围为21至82岁,女性占多数(67.6%),年龄在50 - 64岁之间(45.7%)。大多数为华裔(57.5%),接受过中等教育(43.1%),已婚(65.2%),有工作(64.9%)。18.3%的主要照料者有抑郁症状(基于PHQ - 9评分在10分及以上),而12.7%有焦虑症状(基于GAD - 7评分在10分及以上)。多元线性和逻辑回归分析显示,年龄在35 - 49岁和50 - 64岁之间、失业、与他人同住、照料被诊断为痴呆症患者且FIS得分较高的主要照料者报告抑郁症状的可能性显著更高,而照料儿子/女儿的照料者出现抑郁症状的可能性较小。受教育程度较低、与他人同住、单身或离异/分居、失业且FIS得分较高的主要照料者的生活质量领域得分较低。有抑郁症状的照料者在所有四个领域均与低生活质量显著相关,而有焦虑症状的照料者在社会关系领域与低生活质量显著相关。
本研究中照料者的心理状况与生活质量的各个领域相关。特别是,照料者的抑郁症状在生活质量的所有四个领域均与较低的生活质量显著相关,而焦虑症状与社会关系领域的较低得分相关。该研究表明需要为照料者提供社会支持和心理教育,以改善生活质量并帮助他们制定健康的应对策略。