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北京地区残疾老年人家庭照顾者健康相关生活质量的影响因素:一项横断面研究

Factors associated with health-related quality of life among family caregivers of disabled older adults: a cross-sectional study from Beijing.

作者信息

Du Juan, Shao Shuang, Jin Guang-Hui, Qian Chen-Guang, Xu Wei, Lu Xiao-Qin

机构信息

School of General Practice and Continuing Education, Capital Medical University Andelu Community Health Service Station Hepingli Community Health Service Station, Dongcheng District, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(44):e8489. doi: 10.1097/MD.0000000000008489.

Abstract

Because of the aging population and the shortage of standardized institutional solutions for long-term care (LTC) in China, family caregivers in Beijing are increasingly called upon to provide home care for disabled older adults. Caregivers face a heavy care burden, and decreased physical and mental health (MH). This study aims to describe health-related quality of life (HRQoL) and to identify its predictors for Chinese family caregivers of disabled older adults.A total of 766 caregivers were recruited from 5 communities in the Dongcheng District of Beijing. Measures included the 36-item Short-Form Health Survey (SF-36), the Zarit Caregiver Burden Interview (ZBI) scales, and the Chinese Social Support Rating Scale (SSRS). Hierarchical multiple regression (HMR) analysis was used to identify the predictors.HMR analysis showed that each block of independent variables (demographic characteristics of disabled older adults, demographic characteristics of caregivers, caregiving context, and subjective caregiver burden) had contributed significantly to caregivers' physical and mental quality of life. Subjective caregiver burden explained the greatest amount of total variance in all MH subscales and the 2nd greatest amount of variance in most physical subscales. Therefore, subjective caregiver burden was the strongest predictor of HRQoL.Our findings suggest that a decrease in caregiver burden can improve caregivers' HRQoL, and additional social support is important in decreasing the impact of caregiving on HRQoL. Importantly, an LTC system should be established in China as soon as possible.

摘要

由于中国人口老龄化以及长期护理(LTC)标准化机构解决方案的短缺,北京的家庭照顾者越来越多地被要求为残疾老年人提供居家护理。照顾者面临着沉重的护理负担,身心健康状况下降。本研究旨在描述与健康相关的生活质量(HRQoL),并确定中国残疾老年人家庭照顾者的HRQoL预测因素。

总共从北京东城区的5个社区招募了766名照顾者。测量指标包括36项简短健康调查问卷(SF - 36)、扎里特照顾者负担访谈(ZBI)量表以及中国社会支持评定量表(SSRS)。采用分层多元回归(HMR)分析来确定预测因素。

HMR分析表明,每个自变量组块(残疾老年人的人口统计学特征、照顾者的人口统计学特征、照顾情境以及照顾者主观负担)对照顾者的身心健康生活质量均有显著贡献。照顾者主观负担在所有心理健康子量表中解释的总方差量最大,在大多数生理子量表中解释的方差量排第二。因此,照顾者主观负担是HRQoL的最强预测因素。

我们的研究结果表明,减轻照顾者负担可以改善其HRQoL,额外的社会支持对于减轻护理对HRQoL的影响很重要。重要的是,中国应尽快建立长期护理体系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9fc/5682827/2cc6b3b4d996/medi-96-e8489-g004.jpg

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