Mirinda Brown Tyo, PhD, RN, TCRN, is PhD Student, University of Massachusetts Dartmouth. She is now Corporate Educator, Cape Cod Healthcare, Hyannis, Massachusetts. Mary K. McCurry, PhD, RNC, ANP, ACNP, is Associate Professor, University of Massachusetts Dartmouth.
Nurs Res. 2020 Sep/Oct;69(5):391-398. doi: 10.1097/NNR.0000000000000442.
Family caregivers contribute to engagement in treatment and adherence, reduced substance misuse and relapse, and increased well-being of recipients with substance use disorder. However, providing care has also been associated with negative emotional and physical health outcomes for caregivers. The purpose of this integrative review was to determine what instruments are used to measure caregiver burden in informal caregivers of individuals with substance use disorder.
An integrative review framework was applied to examine empirical and theoretical literature to answer the guiding research question, "How is caregiver burden measured in caregivers of individuals with substance use disorder?" PubMed, CINAHL, and APA PsychINFO were searched using a combination of search terms. The initial 1,198 articles were narrowed to 32 that fit the search criteria and purpose of the review.
A variety of scales have been used to measure caregiver burden. Caregiver burden is operationalized as objective or subjective burden. Objective burden refers to changes in the home, finances, employment, social life, and leisure, whereas subjective burden refers to the emotional reaction of the caregiver in coping with providing care. Caregiver burden was most often reported as moderate to severe in populations with substance use disorder. Attributes measured included anxiety, depression, stress, worry, displeasure, care recipient behavioral problems and substance abuse, stigma, relationship strain, financial expenses, social support, family disruption, and the effect on caregiver physical and emotional health.
Specific instruments that can accurately evaluate objective and subjective caregiver burden are needed to measure the quality of caregiver health. More research is necessary to better understand the physical and emotional health of caregivers of persons with substance use disorder and the factors that contribute to increased quality of life. Understanding the relationship between outcomes and protective factors could help nurses to develop prevention strategies and treatment interventions aimed at decreasing the psychosocial trauma and stress associated with caregiver burden.
家庭照顾者有助于参与治疗和坚持治疗、减少物质滥用和复发，以及提高物质使用障碍患者的幸福感。然而，为照顾者提供照顾也与照顾者的负面情绪和身体健康结果有关。本综合评价的目的是确定用于衡量物质使用障碍患者的非正式照顾者的照顾者负担的工具。
应用综合评价框架来检查实证和理论文献，以回答指导研究问题：“如何衡量物质使用障碍患者的照顾者的照顾者负担？” 使用了组合搜索词对 PubMed、CINAHL 和 APA PsychINFO 进行了搜索。最初的 1198 篇文章被缩小到符合搜索标准和审查目的的 32 篇文章。
已经使用了各种量表来衡量照顾者负担。照顾者负担被操作化为客观或主观负担。客观负担是指家庭、财务、就业、社会生活和休闲方面的变化，而主观负担是指照顾者在应对提供照顾时的情绪反应。在物质使用障碍人群中，照顾者负担通常报告为中度至重度。测量的属性包括焦虑、抑郁、压力、担忧、不满、照顾对象的行为问题和物质滥用、污名、关系紧张、经济支出、社会支持、家庭破裂，以及对照顾者身体和情绪健康的影响。
需要特定的工具来准确评估客观和主观的照顾者负担，以衡量照顾者健康的质量。需要进一步研究以更好地了解物质使用障碍患者的照顾者的身体和情绪健康，以及导致生活质量提高的因素。了解结果和保护因素之间的关系可以帮助护士制定旨在减少与照顾者负担相关的心理社会创伤和压力的预防策略和治疗干预措施。
