Albrecht Diana, Wollensak Tanja, Ernst Christian, Becker Clemens, Hautzinger Martin, Pfeiffer Klaus
Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Auerbachstr 110, 70376 Stuttgart, Germany.
Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University, Schleichstr 4, 72076 Tübingen, Germany.
Eur J Ageing. 2015 Oct 28;13(1):49-61. doi: 10.1007/s10433-015-0356-x. eCollection 2016 Mar.
Stroke is a leading cause of long-term disability. A large proportion of geriatric stroke survivors receive informal care. The assessment and monetary valuation of informal care should therefore constitute an essential part of any health economic analysis, but it is hardly measured in stroke caregiver studies. The aim of the current research was to estimate the amount of informal care provided by caregivers of stroke survivors aged 60 years and older and to calculate its economic value. Information about caregiving time in activities of daily living (ADL), instrumental activities of daily living (IADL), and supervision during the last 3 months was obtained from 122 caregivers by means of structured interviews. The proxy good method was applied for the monetary valuation of time. About 63 % of the stroke survivors in our sample were moderately cognitively impaired. The results showed that the majority of the main caregivers assisted in ADL and IADL. Supervision was delivered by 45.9 %. The median amount of help in ADL was 13.9, in IADL 22.2, and in supervision 13.9 h/week. The median overall amount of care was 42.8 h/week. Fifty percent were supported by additional persons (2.7 h/week). The mean overall costs of informal care were calculated at 2252 €/month. Our results reveal the high social and economic costs of informal care. The main burden of caregiving appears to be carried by the primary caregiver. Consequently, support and counseling of this group is important. Furthermore, caregiver interventions should be aimed at the mobilization of informal resources.
中风是导致长期残疾的主要原因。很大一部分老年中风幸存者接受非正式护理。因此，非正式护理的评估和货币估值应构成任何健康经济分析的重要组成部分，但在中风护理者研究中却很少对此进行衡量。当前研究的目的是估计60岁及以上中风幸存者的护理者提供的非正式护理量，并计算其经济价值。通过结构化访谈从122名护理者那里获取了有关过去3个月日常生活活动（ADL）、工具性日常生活活动（IADL）中的护理时间以及监督情况的信息。采用替代商品法对时间进行货币估值。我们样本中约63%的中风幸存者存在中度认知障碍。结果显示，大多数主要护理者协助进行ADL和IADL。45.9%的护理者提供监督。ADL方面的帮助时长中位数为每周13.9小时，IADL为22.2小时，监督为13.9小时。护理总时长中位数为每周42.8小时。50%的护理者得到其他人的协助（每周2.7小时）。非正式护理的平均总成本计算为每月2252欧元。我们的结果揭示了非正式护理高昂的社会和经济成本。护理的主要负担似乎由主要护理者承担。因此，对这一群体的支持和咨询很重要。此外，护理者干预措施应旨在调动非正式资源。
