1 Southern Adelaide Palliative Services, Daw Park, SA, Australia.
2 Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Palliat Med. 2018 Jan;32(1):257-267. doi: 10.1177/0269216317717370. Epub 2017 Jun 19.
Providing care at end of life has consequences for caregivers' bereavement experience. 'Difficulty moving on with life' is an informative and unbiased symptom of prolonged grief disorder. Predictors of bereaved caregivers' ability to 'move on' have not been examined across the population.
To identify the characteristics of bereaved hands-on caregivers who were, and were not, able to 'move on' 13-60 months after the 'expected' death of someone close.
The South Australian Health Omnibus is an annual, random, cross-sectional community survey. From 2000 to 2007, respondents were asked about providing care for someone terminally ill and their subsequent ability to 'move on'. Multivariable logistic regression models explored the characteristics moving on and not moving on.
Respondents were aged ⩾15 years and lived in households within South Australia. They had provided care to someone who had died of terminal illness in the preceding 5 years.
A total of 922 people provided hands-on care. In all, 80% of caregivers (745) had been able to 'move on'. Closeness of relationship to the deceased, increasing caregiver age, caregiver report of needs met, increasing time since loss, sex and English-speaking background were significantly associated with 'moving on'. A closer relationship to the deceased, socioeconomic disadvantage and being male were significantly associated with not 'moving on'.
These results support the relevance of 'moving on' as an indicator of caregivers' bereavement adjustment. Following the outcomes of bereaved caregivers longitudinally is essential if effective interventions are to be developed to minimise the risk of prolonged grief disorder.
在生命末期提供护理会对护理人员的丧亲体验产生影响。“难以继续生活”是延长哀伤障碍的一个信息丰富且无偏见的症状。尚未在人群中检查过丧亲护理人员“继续前进”能力的预测因素。
确定在接近亲人“预期”死亡后 13-60 个月能够“继续前进”和不能“继续前进”的丧亲实际护理人员的特征。
南澳大利亚健康普查是一项年度、随机、横断面社区调查。从 2000 年到 2007 年,受访者被问及为绝症患者提供护理以及随后他们能够“继续前进”的能力。多变量逻辑回归模型探讨了继续前进和不继续前进的特征。
受访者年龄 ⩾15 岁,居住在南澳大利亚的家庭中。他们在过去 5 年内曾为患有绝症的人提供护理。
共有 922 人提供了实际护理。总共有 80%的护理人员(745 人)能够“继续前进”。与死者关系密切、护理人员年龄增加、护理人员报告需求得到满足、丧失时间增加、性别和英语背景与“继续前进”显著相关。与死者关系密切、社会经济劣势和男性与“不继续前进”显著相关。
这些结果支持“继续前进”作为护理人员丧亲调整的指标的相关性。如果要开发有效的干预措施来最大程度地降低延长哀伤障碍的风险,则必须对丧亲的护理人员进行纵向随访。