Ornstein Katherine, Smith Kristofer L, Boal Jeremy
Columbia University The Mount Sinai Visiting Doctors Program, New York,
The Samuel Bronfman Department of Medicine, The Mount Sinai School of Medicine, New York.
J Appl Gerontol. 2009 Aug;28(4):482-503. doi: 10.1177/0733464808329828.
The growing homebound population is heavily reliant on informal caregivers, who are increasingly burdened by their roles. This study describes informal caregivers of the homebound who remain caregivers at a 9-month follow-up and examines the impact of a home-based primary care (HBPC) program on caregiver burden and unmet needs using a prospective design with a pre-post intervention assessment. Informal caregivers of the urban homebound are similar to caregivers of other populations and have a broad range of unmet needs. The intervention described is the regular provision of multidisciplinary HBPC. Hundred fourteen caregivers of newly admitted patients complete a baseline interview. For the 56 caregivers who complete a 9-month follow-up interview, participation in HBPC is associated with a statistically significant decrease in overall caregiver burden. At 9 months, caregivers demonstrate an overall decrease in unmet needs, with a statistically significant decrease across two measured domains. These results suggest that the regular provision of multidisciplinary care in the home can mitigate the deleterious impact of informal caregiving.
日益增多的居家人口严重依赖非正式护理人员,而这些护理人员的负担也越来越重。本研究描述了居家者的非正式护理人员在9个月随访时仍担任护理工作的情况,并采用干预前后评估的前瞻性设计,研究了居家初级保健(HBPC)项目对护理人员负担和未满足需求的影响。城市居家者的非正式护理人员与其他人群的护理人员相似,有广泛的未满足需求。所描述的干预措施是定期提供多学科HBPC。114名新入院患者的护理人员完成了基线访谈。对于完成9个月随访访谈的56名护理人员来说,参与HBPC与护理人员总体负担在统计学上的显著降低相关。在9个月时,护理人员的未满足需求总体有所减少,在两个测量领域有统计学上的显著下降。这些结果表明,在家中定期提供多学科护理可以减轻非正式护理的有害影响。