中风幸存者照料者的非正式照料、负担及职业倦怠风险的决定因素：CONOCES研究
Determinants of Informal Care, Burden, and Risk of Burnout in Caregivers of Stroke Survivors: The CONOCES Study.
作者信息
Oliva-Moreno Juan, Peña-Longobardo Luz María, Mar Javier, Masjuan Jaime, Soulard Stéphane, Gonzalez-Rojas Nuria, Becerra Virginia, Casado Miguel Ángel, Torres Covadonga, Yebenes María, Quintana Manuel, Alvarez-Sabín Jose
机构信息
From the Department of Economic Analysis, Universidad de Castilla-La Mancha, Toledo, Spain (J.O.-M., L.M.P.-L.); Clinical Management Service, Alto Deba Hospital, Mondragon, Spain (J. Mar); Stroke Unit, Neurology Department, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain (J. Masjuan); Health Economics and Outcomes Research, Boehringer Ingelheim España, Barcelona, Spain (S.S., N.G.-R., V.B.); Pharmacoeconomics and Outcomes Research Iberia, Madrid, Spain (M.Á.C., C.T., M.Y.); and Neurovascular Unit, Department of Neurology, Universitat Autònoma de Barcelona, Hospital Vall d'Hebron, Spain (M.Q., J.A.-S.).
出版信息
Stroke. 2018 Jan;49(1):140-146. doi: 10.1161/STROKEAHA.117.017575. Epub 2017 Nov 28.
BACKGROUND AND PURPOSE
The aim of this article was to analyze the likelihood of receiving informal care after a stroke and to study the burden and risk of burnout of primary caregivers in Spain.
METHODS
The CONOCES study is an epidemiological, observational, prospective, multicenter study of patients diagnosed with stroke and admitted to a Stroke Unit in the Spanish healthcare system. At 3 and 12 months post-event, we estimated the time spent caring for the patient and the burden borne by primary caregivers. Several multivariate models were applied to estimate the likelihood of receiving informal caregiving, the burden, and the likelihood of caregivers being at a high risk of burnout.
RESULTS
Eighty percent of those still alive at 3 and 12 months poststroke were receiving informal care. More than 40% of those receiving care needed a secondary caregiver at 3 months poststroke. The likelihood of receiving informal care was associated with stroke severity and the individual's health-related quality of life. When informal care was provided, both the burden borne by caregivers and the likelihood of caregivers being at a high risk of burnout was associated with (1) caregiving hours; (2) the patient's health-related quality of life; (3) the severity of the stroke measured at discharge; (4) the patient having atrial fibrillation; and (5) the degree of dependence.
CONCLUSIONS
This study reveals the heavy burden borne by the caregivers of stroke survivors. Our analysis also identifies explanatory and predictive variables for the likelihood of receiving informal care, caregiver burden, and high risk of burnout.
背景与目的
本文旨在分析中风后接受非正式护理的可能性，并研究西班牙主要护理人员的负担和倦怠风险。
方法
CONOCES研究是一项针对西班牙医疗系统中被诊断为中风并入住中风单元的患者的流行病学、观察性、前瞻性多中心研究。在事件发生后的3个月和12个月，我们估计了照顾患者的时间以及主要护理人员所承担的负担。应用了多个多变量模型来估计接受非正式护理的可能性、负担以及护理人员处于高度倦怠风险的可能性。
结果
中风后3个月和12个月仍存活的患者中，80%接受了非正式护理。超过40%接受护理的患者在中风后3个月需要二级护理人员。接受非正式护理的可能性与中风严重程度和个人的健康相关生活质量有关。当提供非正式护理时，护理人员承担的负担以及护理人员处于高度倦怠风险的可能性与以下因素有关：（1）护理时长；（2）患者的健康相关生活质量；（3）出院时测量的中风严重程度；（4）患者患有心房颤动；（5）依赖程度。
结论
本研究揭示了中风幸存者护理人员所承担的沉重负担。我们的分析还确定了接受非正式护理的可能性、护理人员负担和高度倦怠风险的解释性和预测性变量。
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