Department of Psychology, National University of Singapore, Singapore.
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
Perit Dial Int. 2019 Mar-Apr;39(2):176-180. doi: 10.3747/pdi.2018.00049.
Peritoneal dialysis (PD) is advocated as treatment of choice for most end-stage renal disease (ESRD) patients, including elderly and frail patients. It typically requires caregiver involvement to support care at home. The purpose of this study was to examine changes in burden and quality of life (QOL) in caregivers of prevalent PD patients over 12 months. Data were collected in 44 caregivers of PD patients (mean age 38.4 ± 6.3 years; 60% female) in Singapore at baseline and 12 months. Measures included demographics, the Lay Care-Giving for Adults Receiving Dialysis (LC-GAD), Zarit Burden Interview (ZBI), and the World Health Organization Quality of Life instrument (WHOQOL-BREF). Paired -tests indicate a significant decrease in task-related aspects of caregiving ( = 0.04), particularly in relation to personal hygiene ( < 0.01), over time. Cognitive aspects of caregiving remained unchanged. Perceived burden, however, significantly increased ( < 0.01), with significantly more caregivers reporting moderate to severe caregiver burden at follow-up (28%) relative to baseline (13%; < 0.01). There was a significant reduction in psychological health (under WHOQOL) ( = 0.01). Study findings indicate an increase in caregiver burden and a reduction in psychological health despite a reduction in task-related aspects of caregiving, supporting a further exploration of the "wear-and-tear" hypothesis among this population. Intervention strategies are needed.
腹膜透析（PD）被提倡作为大多数终末期肾病（ESRD）患者的治疗选择，包括老年和体弱患者。它通常需要照顾者的参与，以支持家庭护理。本研究的目的是在 12 个月内研究 PD 患者的照顾者负担和生活质量（QOL）的变化。在新加坡，在基线和 12 个月时，对 44 名 PD 患者（平均年龄 38.4 ± 6.3 岁；60%为女性）的照顾者收集了数据。测量包括人口统计学、成人接受透析的日常护理照顾（LC-GAD）、Zarit 负担访谈（ZBI）和世界卫生组织生活质量量表（WHOQOL-BREF）。配对检验表明，随着时间的推移，照顾者的任务相关方面（ = 0.04），特别是个人卫生方面（ < 0.01），显著减少。照顾的认知方面没有变化。然而，感知负担显著增加（ < 0.01），随访时报告中度至重度照顾者负担的照顾者比例（28%）明显高于基线（13%； < 0.01）。心理健康（在 WHOQOL 下）显著降低（ = 0.01）。研究结果表明，尽管与任务相关的照顾方面有所减少，但照顾者的负担增加，心理健康下降，支持在这一人群中进一步探索“磨损”假说。需要干预策略。
