慢性病患儿家庭照顾者的心理社会状况：一项横断面研究。
The psychosocial profile of family caregivers of children with chronic diseases: a cross-sectional study.
作者信息
Toledano-Toledano Filiberto, Luna David
机构信息
Evidence-Based Medicine Research Unit, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, 06720 México City, Mexico.
Comisión Nacional de Arbitraje Médico, Mitla No. 250-8° Piso, esq. Eje 5 Sur (Eugenia). Vertiz Narvarte, 03020, Benito Juárez, Mexico City, Mexico.
出版信息
Biopsychosoc Med. 2020 Oct 22;14:29. doi: 10.1186/s13030-020-00201-y. eCollection 2020.
BACKGROUND
A family caregiver is defined as a person who has a significant emotional bond with the patient; this caregiver is a family member who is a part of the patient's family life cycle; offers emotional-expressive, instrumental, and tangible support; and provides assistance and comprehensive care during the chronic illness, acute illness, or disability of a child, adult, or elderly person. The objectives of this study were to identify the psychosocial profiles of family caregivers of children with chronic diseases and to establish the relationship between these profiles and sociodemographic variables.
METHODS
A cross-sectional study was conducted involving 401 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic disease and a battery of 7 instruments that examined anxiety, caregiver burden, family support, depression, resilience, parental stress, and the World Health Organization Well-Being Index
RESULTS
A hierarchical cluster analysis and its confirmation through a nonhierarchical cluster analysis confirmed two profiles of caregivers of pediatric patients with chronic diseases. Profile 1, called , is characterized by high levels of anxiety, depression, parental stress and caregiver burden, accompanied by low levels of family support, resilience, and well-being. Profile 2, called , shows an inverse pattern, with high levels of family support, resilience, and well-being and low levels of anxiety, depression, parental stress and caregiver burden. The sociodemographic characteristics are similar for both profiles, with the exception of the caregiver's family type. Profile 1 shows more single-parent caregivers, while profile 2 includes more caregivers with a nuclear family. However, the type of family did not reach significance for predicting the caregiver's profile in a bivariate logistic regression model.
CONCLUSIONS
The psychosocial profile of family caregivers of children with chronic diseases can be structured according to their psychosocial characteristics. Although no causal factors were detected that define criteria for belonging to one or another profile, the characteristics identified for each indicate the need for specific and differentiated intervention strategies for families facing adversity, risk and vulnerability during a child's disease.
背景
家庭照顾者被定义为与患者有深厚情感纽带的人；该照顾者是患者家庭生命周期的一部分，属于家庭成员；提供情感表达、工具性和实际支持；并在儿童、成人或老年人患慢性病、急性病或残疾期间提供协助和全面护理。本研究的目的是确定慢性病患儿家庭照顾者的心理社会特征，并建立这些特征与社会人口学变量之间的关系。
方法
在墨西哥城的国立卫生研究院对401名慢性病患儿的家庭照顾者进行了一项横断面研究。参与者回答了用于研究慢性病患儿家庭照顾者的社会人口学变量问卷（Q-SV）以及一系列7种工具，这些工具用于检测焦虑、照顾者负担、家庭支持、抑郁、心理弹性、父母压力和世界卫生组织幸福指数。
结果
通过分层聚类分析及其通过非分层聚类分析的确认，确定了慢性病患儿家庭照顾者的两种特征。特征1，称为 ，其特点是焦虑、抑郁、父母压力和照顾者负担水平高，同时家庭支持、心理弹性和幸福感水平低。特征2，称为 ，呈现相反的模式，家庭支持、心理弹性和幸福感水平高，焦虑、抑郁、父母压力和照顾者负担水平低。两种特征的社会人口学特征相似，但照顾者的家庭类型除外。特征1显示单亲照顾者更多，而特征2包括更多核心家庭的照顾者。然而，在二元逻辑回归模型中，家庭类型对预测照顾者特征未达到显著水平。
结论
慢性病患儿家庭照顾者的心理社会特征可根据其心理社会特征进行构建。尽管未检测到确定属于一种或另一种特征标准的因果因素，但为每种特征确定的特征表明，对于在孩子患病期间面临逆境、风险和脆弱性的家庭，需要采取具体且有区别的干预策略。
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