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帕金森病患者中照顾者压力的严重程度与疾病严重程度的关系

Severity of Caregiver Stress in Relation to Severity of Disease in Persons with Parkinson's.

作者信息

Kumar Haresh, Ansari Shahbaz, Kumar Vikash, Barry Habiba D, Tahir Amber

机构信息

Internal Medicine, United Medical and Dental College, Karachi, PAK.

Internal Medicine, Jinnah Postgraduate Medical Center, Karachi, PAK.

出版信息

Cureus. 2019 Apr 1;11(4):e4358. doi: 10.7759/cureus.4358.

Abstract

Introduction Parkinson's disease (PD) is a progressive neurological disorder. It presents with motor symptoms and gradually progresses to cognitive impairment. It has debilitating impact not only on the psychological health of the patient but also of the caregivers. The aim of this study is to evaluate the stress level among caregivers of PD and assess its correlation with the disease factors including duration, severity, and presence of on-off phenomenon. Methods One hundred and fifty-six patients of Parkinson's disease and their caregivers were enrolled. Severity of Parkinson's disease was assessed using Hoehn and Yahr Scale. Caregiver stress was evaluated using Caregiver Burden Inventory. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM Corp., Armonk, NY, USA). Results There were 112 (71.8%) women and 44 (28.2%) men in the caregiver group. Their mean age was 47.75 ± 11.98 years. There were 98 (62.8%) stressed caregivers and 58 (37.2%) non-stressed caregivers. In patients with stage 4 and 5 PD, 67-80% caregivers were stressed as compared to only 28% caregivers of stage 1 PD (p-value = 0.0008). Duration of Parkinson's disease more than 10 years and presence of on-off phenomenon was also significantly associated with higher stress in the caregivers (p-value < 0.00001; p-value = 0.002, respectively). Among the stressed caregivers, 85 (86.7%) were women and only 13 (13.3%) were men (p-value < 0.0001). Conclusion Psychological health of caregivers of persons with Parkinson's is bleak. As the disease progresses, they further succumb to debilitating stress and depression. Qualitative and quantitative studies must be conducted in Pakistan to understand the psychosocial status of Parkinson's disease caregivers and plan strategies to improve their quality of life.

摘要

引言

帕金森病(PD)是一种进行性神经疾病。它表现为运动症状,并逐渐发展为认知障碍。它不仅对患者的心理健康,而且对照顾者的心理健康都有削弱性影响。本研究的目的是评估帕金森病患者照顾者的压力水平,并评估其与疾病因素(包括病程、严重程度和开关现象的存在)之间的相关性。

方法

招募了156名帕金森病患者及其照顾者。使用Hoehn和Yahr量表评估帕金森病的严重程度。使用照顾者负担量表评估照顾者的压力。数据使用社会科学统计软件包(SPSS)22.0版(美国纽约州阿蒙克市IBM公司)录入和分析。

结果

照顾者组中有112名(71.8%)女性和44名(28.2%)男性。他们的平均年龄为47.75±11.98岁。有98名(62.8%)有压力的照顾者和58名(37.2%)无压力的照顾者。在4期和5期帕金森病患者中,67 - 80%的照顾者有压力,而1期帕金森病患者的照顾者中只有28%有压力(p值 = 0.0008)。帕金森病病程超过10年和存在开关现象也与照顾者的高压力显著相关(p值分别<0.00001;p值 = 0.002)。在有压力的照顾者中,85名(86.7%)是女性,只有13名(13.3%)是男性(p值<0.0001)。

结论

帕金森病患者照顾者的心理健康状况不佳。随着疾病进展,他们更容易受到削弱性压力和抑郁的影响。必须在巴基斯坦进行定性和定量研究,以了解帕金森病照顾者的心理社会状况,并制定改善他们生活质量的策略。

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本文引用的文献

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The burden of Parkinson's disease: a worldwide perspective.帕金森病的负担:全球视角。
Lancet Neurol. 2018 Nov;17(11):928-929. doi: 10.1016/S1474-4422(18)30355-7. Epub 2018 Oct 1.
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Social phobia in Parkinson's disease: Prevalence and risk factors.帕金森病患者的社交恐惧症:患病率和危险因素。
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Lancet Neurol. 2006 Jun;5(6):525-35. doi: 10.1016/S1474-4422(06)70471-9.

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