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老年人的虚弱对其非正式照料者与照料相关的生活质量随时间的影响:TOPICS-MDS项目的结果

The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

作者信息

Oldenkamp Marloes, Hagedoorn Mariët, Wittek Rafael, Stolk Ronald, Smidt Nynke

机构信息

Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.

The Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands.

出版信息

Qual Life Res. 2017 Oct;26(10):2705-2716. doi: 10.1007/s11136-017-1606-5. Epub 2017 May 31.

Abstract

PURPOSE

To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver.

METHODS

Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities).

RESULTS

660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person's frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person's psychological well-being was most important for the caregiver's care-related quality of life, compared to the other health domains.

CONCLUSIONS

Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.

摘要

目的

探讨老年人衰弱状况的变化对其非正式照料者与照料相关的生活质量的影响。

方法

从TOPICS-MDS数据库中选取了5个研究项目,这些项目包含了老年人及其非正式照料者在基线期和随访12个月后的相关数据。从五个健康领域(功能受限、心理健康、社会功能、健康相关生活质量、自评健康)对衰弱进行评估。使用与照料相关的生活质量量表(CarerQoL-7D)来衡量与照料相关的生活质量,该量表包含两个积极维度(成就感、感知到的支持)和五个消极维度(关系问题、心理健康问题、身体健康问题、经济问题、将非正式照料与日常活动相结合的问题)。

结果

纳入了660对老年人/照料者夫妇。老年人的平均年龄为79岁(标准差为6.9),女性占61%。照料者的平均年龄为65岁(标准差为12.6),女性占68%。多变量线性和逻辑回归分析结果显示,随着时间推移老年人衰弱状况的加重与照料者与照料相关的总体生活质量降低、更多的心理和身体健康问题以及随访时将非正式照料与日常活动相结合的问题有关。与其他健康领域相比,老年人心理健康状况的变化对照料者与照料相关的生活质量影响最为重要。

结论

健康专业人员若观察到老年人心理健康状况下降且非正式照料时长增加,应意识到这可能给其非正式照料者带来的诸多问题,并应根据照料者的具体需求和问题,量身定制干预措施以支持他们。

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