Ertem Devrimsel Harika, Ilik Faik
University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Department of Neurology, Istanbul, Turkey.
KTO Karatay University, Medical Faculty Affiliated Konya Medicana Hospital, Department of Neurology, Konya, Turkey.
Clin Nutr ESPEN. 2019 Oct;33:154-157. doi: 10.1016/j.clnesp.2019.06.002. Epub 2019 Jun 21.
BACKGROUND & AIMS: Malnutrition problems are very common after a stroke. Several clinical studies have shown the contribution of percutaneous endoscopic gastrostomy (PEG) feeding after stroke in terms of improving nutritional status and reducing mortality. The aim of this study is to compare the burden and depression among caregivers of ischemic stroke patients fed with PEG and orally.
A total of 63 caregivers of patients with acute ischemic stroke who were followed up in the neurointensive care unit with modified Rankin Scale 4 or 5 were recruited in this cross-sectional survey. Clinical data of patients and demographical profile as age, gender, kinship to patient, income, and level of education of caregivers were recorded. On their 3rd-month follow-up visit, Beck Depression Inventory and The Zarit Burden Interview (ZBI) were administered to caregivers to evaluate depressive symptoms and caregiver burden. A semi-structured questionnairre was developed and conducted by the researchers with the caregivers to assess their thoughts of nutrition.
Thirty-two caregivers of stroke patients on PEG and 31 caregivers of stroke patients who were fed orally were evaluated. The groups did not differ statistically in terms of demographic variables and depression scores (p > 0.05). However, the mean score of ZBI was significantly higher in the group of caregivers of stroke patients who were fed orally (p = 0.00). Caregivers of stroke patients on PEG had higher scores of caregivers' thoughts of nutrition support therapy questionnairre (p = 0.00).
Our findings demonstrate that caregivers of stroke patients report lower burden and higher level of positive thinking with PEG feeding than oral feeding. This suggests that nutritional care could include convenient and practicable methods for caregivers of patients with stroke in order to meet patients' nutritional requirements.
中风后营养不良问题非常常见。多项临床研究表明，中风后经皮内镜下胃造口术（PEG）喂养在改善营养状况和降低死亡率方面具有作用。本研究的目的是比较接受PEG喂养和经口喂养的缺血性中风患者的照料者的负担及抑郁情况。
在这项横断面调查中，招募了63名在神经重症监护病房接受随访、改良Rankin量表评分为4或5分的急性缺血性中风患者的照料者。记录患者的临床数据以及照料者的人口统计学资料，如年龄、性别、与患者的亲属关系、收入和教育程度。在他们随访的第3个月，对照料者进行贝克抑郁量表和 Zarit 负担访谈（ZBI），以评估抑郁症状和照料者负担。研究人员编制了一份半结构化问卷，并与照料者进行调查，以评估他们对营养的看法。
对32名接受PEG喂养的中风患者的照料者和31名经口喂养的中风患者的照料者进行了评估。两组在人口统计学变量和抑郁评分方面无统计学差异（p>0.05）。然而，经口喂养的中风患者的照料者组的ZBI平均得分显著更高（p = 0.00）。接受PEG喂养的中风患者的照料者在照料者对营养支持治疗问卷上的得分更高（p = 0.00）。
我们的研究结果表明，与经口喂养相比，接受PEG喂养的中风患者的照料者报告的负担更低，积极思维水平更高。这表明营养护理可以包括为中风患者的照料者提供方便可行的方法，以满足患者的营养需求。
