SIES SALUD, Bogotá, Colombia.
PhD Program in Public Health, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Palliat Support Care. 2020 Jun;18(3):332-338. doi: 10.1017/S1478951519000749.
The growing aging population and the high prevalence of several concomitant chronic diseases have contributed to the elevated rates of caregiver burden and suffering in patients. In turn, intending to relieve unnecessary pain in patients, there has been a rapid growth of outpatient palliative care programs. However, little has been studied about caregiver burden as a relevant factor potentially affecting the effectiveness of these programs. This study aimed to determine the extent of caregiver burden as a possible mediator on the effectiveness of a home-based palliative care program.
Sixty-six palliative patients (56% women; mean age + SD = 71, 6 ± 17.7) and their caregivers were assessed with measures for physical, emotional, and psychological symptoms before and 1 month after the start of a home-based palliative care program.
The association between caregiver burden and palliative outcomes was corroborated with a categorical regression model (p < 0.01). Caregiver burden was found to be a significant mediator in the relationship between outcome measures for palliative care at baseline and after 1 month of enrollment in the program.
To our knowledge, this is the first study to assess the role of caregiver burden in the effectiveness of a home-based palliative care program. Although further work is required, the results indicate that a patient-focused intervention does not have the same beneficial effect if the caregiver burden is not addressed. Future home-based palliative care programs should focus on caregivers as well as patients, with particular attention to psychosocial intervention on caregivers.
人口老龄化的加剧以及多种并存的慢性疾病的高发，导致患者的照顾者负担和痛苦程度增加。为了减轻患者不必要的痛苦，门诊姑息治疗项目迅速发展。然而，对于照顾者负担作为一个潜在的影响这些项目效果的相关因素，研究甚少。本研究旨在确定照顾者负担的程度，作为一个可能的中介因素，对家庭姑息治疗项目的效果产生影响。
66 名姑息治疗患者（56%为女性；平均年龄+标准差=71.6±17.7）及其照顾者在家庭姑息治疗项目开始前和开始后 1 个月接受了身体、情绪和心理症状的评估。
基于类别回归模型，验证了照顾者负担与姑息治疗结果之间的关联（p<0.01）。在基线时姑息治疗结果测量与项目开始后 1 个月之间的关系中，照顾者负担被发现是一个显著的中介因素。
据我们所知，这是第一项评估家庭姑息治疗项目中照顾者负担对效果的作用的研究。尽管还需要进一步的工作，但结果表明，如果不解决照顾者的负担问题，以患者为中心的干预措施不会产生相同的有益效果。未来的家庭姑息治疗项目应同时关注患者和照顾者，特别关注照顾者的心理社会干预。
