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血管性下肢截肢后与照顾者的关系质量、抑郁和生活满意度。

Quality of Relationships With Caregivers, Depression, and Life Satisfaction After Dysvascular Lower Extremity Amputation.

机构信息

Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA.

Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.

出版信息

Arch Phys Med Rehabil. 2018 Mar;99(3):452-458. doi: 10.1016/j.apmr.2017.09.110. Epub 2017 Oct 5.

Abstract

OBJECTIVE

To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA).

DESIGN

Cross-sectional cohort study using self-report surveys.

SETTING

Department of Veterans Affairs, academic medical center, and level I trauma center.

PARTICIPANTS

Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction.

RESULTS

In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms.

CONCLUSIONS

The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict.

摘要

目的

描述首次发生血管性下肢截肢(LEA)的个体中,照顾者特异性支持与冲突和心理社会结局之间的关系。

设计

使用自我报告调查的横断面队列研究。

地点

退伍军人事务部、学术医疗中心和一级创伤中心。

参与者

因外周动脉疾病(PAD)或糖尿病并发症而首次接受主要 LEA 的个体,且有照顾者,并完成了照顾者支持和冲突的测量(N=137;94.9%为男性)。

干预措施

不适用。

主要结局测量指标

使用患者健康问卷-9 评估抑郁,使用生活满意度量表评估生活满意度。

结果

在多元回归分析中,控制整体感知支持水平、自我报告的健康状况、年龄和活动能力,发现照顾者特异性支持与更高的生活满意度相关,而照顾者特异性冲突与更低的生活满意度和更高的抑郁症状水平相关。

结论

肢体丧失者与他们的照顾者之间的特定关系可能是幸福感的一个重要决定因素。迄今为止,在肢体丧失文献中很少受到关注的与照顾者的冲突似乎起着特别重要的作用。肢体丧失者可能受益于与照顾者的干预措施,这些干预措施既能增强支持,又能减少冲突。

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