Yanny Beshoy, Pham Nguyen V, Saleh Hussein, Saab Sammy
Department of Medicine, University of California at Los Angeles, CA, USA.
Department of Surgery, University of California at Los Angeles, CA, USA.
J Clin Transl Hepatol. 2020 Jun 28;8(2):127-134. doi: 10.14218/JCTH.2019.00054. Epub 2020 Apr 7.
Being a caregiver for a patient with chronic liver disease (CLD) can be burdensome mentally, emotionally financially, and physically. The aim of this study was to systemically review the available tools and propose tools that can comprehensively evaluate caregiver burden for individuals caring for patients with CLD. We searched the PubMed database for all studies on the impact of patients with CLD on caregiver burden without timeframe restriction. Eligible studies included cohort studies, review studies, or cross-sectional studies. The number of patients and caregivers was isolated from each paper. Studies in the same categories were isolated and statistically compared. A total of 13 studies meeting our inclusion criteria as stated in the methods sections were included. In total, 2528 caregivers were taking care of 2003 patients with CLD. Women made up the majority of caregivers at 78.2%, 95.7% of whom identified as the patient's spouse. Caregiver strain index is one of the most comprehensive tools; however, the questions are very general and do not fully elucidate financial strain. Beck depression and anxiety were correlated (=0.0001), and both depression and anxiety were correlated with perceived caregiver burden (PCB) and Zarit Burden Interview (ZBI) (=0.002). Depression scale correlated with Interpersonal Support Evaluation - Short Form, and Model for End-Stage Liver Disease score correlated with ZBI and PCB (total and in most domains; =0.001). Patient's poorer cognitive performance correlated with higher ZBI and PCB (employed patients had higher cognitive performance and lower ZBI and PCB). Caregiver burden remains poorly understood due to the lack of uniformity in the assessment tools used to evaluate caregiver burden. None of the tools used to evaluate caregiver burden are comprehensive; however, most tools correlate statistically in the ability to identify caregiver burden. A comprehensive tool is lacking for identifying caregiver burden in patients with CLD.
照顾慢性肝病（CLD）患者对照顾者来说在精神、情感、经济和身体方面都可能是沉重的负担。本研究的目的是系统地回顾现有的工具，并提出能够全面评估照顾CLD患者的照顾者负担的工具。我们在PubMed数据库中搜索了所有关于CLD患者对照顾者负担影响的研究，没有时间限制。符合条件的研究包括队列研究、综述研究或横断面研究。从每篇论文中分离出患者和照顾者的数量。对同一类别的研究进行分离并进行统计学比较。总共纳入了13项符合我们在方法部分所述纳入标准的研究。总共有2528名照顾者照顾2003名CLD患者。女性占照顾者的大多数，为78.2%，其中95.7%为患者的配偶。照顾者压力指数是最全面的工具之一；然而，问题非常笼统，没有充分阐明经济压力。贝克抑郁量表和焦虑量表相关（=0.0001），抑郁和焦虑都与感知照顾者负担（PCB）和扎里特负担访谈（ZBI）相关（=0.002）。抑郁量表与人际支持评估简表相关，终末期肝病模型评分与ZBI和PCB相关（总体和大多数领域；=0.001）。患者较差的认知表现与较高的ZBI和PCB相关（就业患者认知表现较高，ZBI和PCB较低）。由于用于评估照顾者负担的评估工具缺乏统一性，照顾者负担仍然知之甚少。用于评估照顾者负担的工具都不全面；然而，大多数工具在识别照顾者负担的能力上具有统计学相关性。目前缺乏一种全面的工具来识别CLD患者的照顾者负担。
