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对秘鲁利马一名中风幸存者的护理探索:情感影响、压力因素、应对机制及非正式护理人员未满足的需求

An exploration into caring for a stroke-survivor in Lima, Peru: Emotional impact, stress factors, coping mechanisms and unmet needs of informal caregivers.

作者信息

Pesantes M Amalia, Brandt Lena R, Ipince Alessandra, Miranda J Jaime, Diez-Canseco Francisco

机构信息

CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendáriz 497, Miraflores, Lima, Peru.

Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb. Ingeniería, San Martín de Porres, Lima, Peru.

出版信息

eNeurologicalSci. 2017 Mar;6:33-50. doi: 10.1016/j.ensci.2016.11.004. Epub 2016 Nov 5.

Abstract

INTRODUCTION

Understanding local complexities and challenges of stroke-related caregiving are essential to develop appropriate interventions. Our study aimed to characterize the impact of post-stroke care among caregivers in a setting of transitioning economy.

MATERIALS AND METHODS

Qualitative study based on in-depth interviews with primary caregivers of stroke survivors in Lima, Peru. Transcribed data was organized into the emotional impact of caregiving, main stress factors and coping mechanisms to deal with the caregiving role, as well as the unmet needs of caregivers.

RESULTS

We interviewed twelve caregivers, mean age 52.5 years, 8/12 were females, who were either the spouse or child of the stroke survivor. Stroke patients had a median age of 70 years, range 53-85 years. All participants reported having experienced emotional stress and depressive symptoms as a result of caregiving. Although most had family support, reduced social activities and added unanticipated financial burdens increased caregiver's stress. None of the caregivers had received training in post-stroke care tasks after the patient's discharge and only a few had received some psychological support, yet almost all expressed the need to see a professional to improve their mental health. Keeping a positive attitude towards their relative's physical post-stroke condition was a key coping mechanism.

CONCLUSIONS

In the absence of structured institutional responses, family members endure with the provision of care for stroke survivors, a task escorted by major emotional, financial, and social strains. This burden could be prevented or curtailed if caregivers were to be targeted by interventions providing psychological and financial support, together with basic training on post-stroke care.

摘要

引言

了解中风相关护理的当地复杂性和挑战对于制定适当的干预措施至关重要。我们的研究旨在描述在经济转型背景下中风后护理对照料者的影响。

材料与方法

基于对秘鲁利马中风幸存者主要照料者的深入访谈进行定性研究。转录的数据被整理为护理的情感影响、主要压力因素和应对护理角色的机制,以及照料者未满足的需求。

结果

我们采访了12名照料者,平均年龄52.5岁,其中8/12为女性,她们是中风幸存者的配偶或子女。中风患者的年龄中位数为70岁,范围在53 - 85岁之间。所有参与者都报告称由于护理而经历了情绪压力和抑郁症状。尽管大多数人有家庭支持,但社交活动减少和意外增加的经济负担加重了照料者的压力。没有一名照料者在患者出院后接受过中风后护理任务的培训,只有少数人得到了一些心理支持,但几乎所有人都表示需要寻求专业帮助来改善他们的心理健康。对亲属中风后的身体状况保持积极态度是关键的应对机制。

结论

在缺乏结构化机构应对措施的情况下,家庭成员承担起照顾中风幸存者的责任,这项任务伴随着重大的情感、经济和社会压力。如果针对照料者提供心理和经济支持以及中风后护理的基础培训等干预措施,这种负担是可以预防或减轻的。

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