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照料者负担和生活质量在参加记忆门诊 2 年后的变化。

Caregiver burden and quality of life 2 years after attendance at a memory clinic.

机构信息

Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

Int J Geriatr Psychiatry. 2019 May;34(5):647-656. doi: 10.1002/gps.5060. Epub 2019 Feb 28.

Abstract

OBJECTIVES

We aimed to describe (1) the burden and health-related quality of life (HRQL) of informal caregivers of new patients attending a memory assessment service (MAS), (2) changes in these outcomes over 2 years, and (3) satisfaction with services.

METHODS

Informal caregivers of patients attending one of 73 MASs throughout England completed questionnaires at the patient's first appointment, and 6 and 12 months later. Participants from 30 of these MASs were also followed up at 24 months. Questionnaires covered caregivers' sociodemographic characteristics, Zarit Burden Interview, EQ-5D-3L, and satisfaction with services. We used multivariable linear regression to assess relationships between burden, HRQL, and caregiver and patient characteristics.

RESULTS

Of 1020 caregivers at baseline, 569 were followed up at 6 months, 452 at 12 months, and 187 at 24 months. There was a small increase in caregiver burden over 2 years (effect size 0.30 SD). These changes were not associated with most caregiver or patient characteristics, except socio-economic deprivation, which was associated with larger increases in burden at 2 years. Caregivers' HRQL was weakly associated with burden and showed a small reduction over time (0.2 SD). Most caregivers were satisfied with services, but caregivers who were not satisfied with the services they received reported greater increases in burden.

CONCLUSIONS

Increases in caregiver burden and reductions in HRQL appear to be small over the first 2 years after attending a MAS. However, the longer term impact on caregivers and those they care for needs investigating, as do strategies to reduce their burden.

摘要

目的

我们旨在描述(1)新患者就诊于记忆评估服务(MAS)的非正式照顾者的负担和健康相关生活质量(HRQL),(2)这些结果在 2 年内的变化,以及(3)对服务的满意度。

方法

参加英格兰 73 个 MAS 之一的患者的非正式照顾者在患者首次就诊时以及 6 个月和 12 个月后完成了调查问卷。来自这些 MAS 中的 30 个的参与者也在 24 个月时进行了随访。调查问卷涵盖了照顾者的社会人口统计学特征、Zarit 负担访谈、EQ-5D-3L 和对服务的满意度。我们使用多变量线性回归来评估负担、HRQL 以及照顾者和患者特征之间的关系。

结果

在基线时的 1020 名照顾者中,有 569 名在 6 个月时进行了随访,452 名在 12 个月时进行了随访,187 名在 24 个月时进行了随访。在 2 年内,照顾者的负担略有增加(效应大小为 0.30 SD)。这些变化与大多数照顾者或患者特征无关,除了社会经济贫困,这与 2 年内负担的增加更大有关。照顾者的 HRQL 与负担弱相关,并且随着时间的推移呈现出轻微的下降(0.2 SD)。大多数照顾者对服务满意,但对服务不满意的照顾者报告负担增加更大。

结论

在参加 MAS 后的头 2 年内,照顾者的负担增加和 HRQL 降低似乎很小。然而,需要调查对照顾者及其照顾者的长期影响,以及减少其负担的策略。

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