Pneumology Department, Alvaro Cunqueiro University Hospital, NeumoVigo I+i Research Group, Institute of Health Research Galicia Sur (IISGS), Vigo, Spain.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago, Spain.
Int J Chron Obstruct Pulmon Dis. 2021 Apr 20;16:1119-1126. doi: 10.2147/COPD.S301637. eCollection 2021.
To increase our knowledge of the patient variables related to the overburden of the caregivers of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs).
This was a cross-sectional study of patients with severe COPD who have informal caregivers. We performed a multivariate analysis of sociodemographic (economic situation, care, dependence, social risk, and use of social services) and clinical (degree of dyspnea, previous hospitalizations, disease impact, pulmonary function, and comorbidity) factors and related these to the burden of informal caregivers, as evaluated using the Zarit scale.
The study included 91 patients, age 72.6±8.7 years and 80 were male (89.7%); the mean modified Medical Research Council dyspnea scale (mMRC) score was 2.5±0.8; mean FEV was 39.5 ± 13.2%; and 70 patients (76.9%) were dependent for basic activities. Of the informal caregivers, 90 (90.9%) were women, 49 (49.4%) were partners or spouses, and 29 (29.6%) were daughters. The mean Zarit questionnaire score was 51.4±14.2, with 63 of carers (69.2%) perceiving some overburden, and 34 (37.4%) describing the overburden as mild-moderate. The variables related to informal caregiver overburden in the multivariate study were the previous use of social resources [OR = 8.1 (95% CI = 1.03-69.9); = 0.04], degree of mMRC dyspnea 3-4 [OR =4.7 (95% CI = 1.7-13.2); = 0.003], and two or more admissions for AEPOC in the previous year [OR = 4.5 (95% CI = 1.7-13.2); = 0.003]. Of the informal caregivers of patients who had presented two or more of these variables, 92.3% perceived an overburden.
The variables associated with overburden are easily accessible in patient medical records, or can be obtained by interviewing patients or their relatives. This information would allow to detect and assess the overburden of informal caregivers to provide an early warning of this problem.
增加我们对与慢性阻塞性肺疾病急性加重（AECOPD）患者护理人员负担相关的患者变量的了解。
这是一项对患有严重 COPD 且有非正式照顾者的患者的横断面研究。我们对社会人口统计学（经济状况、护理、依赖、社会风险和社会服务利用）和临床（呼吸困难程度、以前的住院治疗、疾病影响、肺功能和合并症）因素进行了多变量分析，并将这些因素与使用 Zarit 量表评估的非正式照顾者的负担相关联。
该研究纳入了 91 名患者，年龄 72.6±8.7 岁，80 名男性（89.7%）；平均改良医学研究委员会呼吸困难量表（mMRC）评分为 2.5±0.8；平均 FEV 为 39.5±13.2%；70 名患者（76.9%）需要基本活动的帮助。在非正式照顾者中，90 名（90.9%）为女性，49 名（49.4%）为伴侣或配偶，29 名（29.6%）为女儿。Zarit 问卷的平均得分为 51.4±14.2，63 名照顾者（69.2%）认为有一定负担，34 名（37.4%）认为负担为轻度至中度。多变量研究中与非正式照顾者负担相关的变量是以前使用社会资源[比值比（OR）=8.1（95%置信区间（CI）=1.03-69.9）；P=0.04]、mMRC 呼吸困难 3-4 级[OR=4.7（95%CI=1.7-13.2）；P=0.003]和前一年两次或以上因 AEPOC 住院[OR=4.5（95%CI=1.7-13.2）；P=0.003]。在出现两个或多个这些变量的患者的非正式照顾者中，92.3%的人认为负担过重。
与负担过重相关的变量在患者的病历中很容易获得，或者可以通过询问患者或其亲属获得。这些信息将有助于发现和评估非正式照顾者的负担过重情况，从而对这一问题发出早期预警。
