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脑瘫患儿父母的照护者负担与焦虑和抑郁症状严重程度以及潜在区分负担水平的因素的比较:一项横断面研究(波兰)。

Caregiver burden versus intensity of anxiety and depression symptoms in parents of children with cerebral palsy as well as factors potentially differentiating the level of burden: a cross-sectional study (Poland).

机构信息

Medical College, University of Rzeszów, Rzeszow, Poland

出版信息

BMJ Open. 2021 Jun 18;11(6):e036494. doi: 10.1136/bmjopen-2019-036494.

Abstract

OBJECTIVES

To assess the relationship between caregiver burden and severity of symptoms of anxiety/depression in parents of children with cerebral palsy (CP), and to identify factors differentiating the level of caregiver burden.

SETTING

Regional rehabilitation centres in South-Eastern Poland.

PARTICIPANTS

The study involved 190 parents of children with CP, that is, 138 women and 52 men.

PRIMARY AND SECONDARY OUTCOME MEASURES

Caregiver burden was assessed using Caregiver Burden Scale (CBS), while the intensity of anxiety and depression symptoms was measured using Hospital Anxiety and Depression Scale (HADS). Potential predictors were examined using Gross Motor Function Classification System for Cerebral Palsy (GMFCS), Barthel Index (BI) as well as a questionnaire focusing on the characteristics of the child, the parent and the family. The analyses applied Pearson's linear correlation coefficient as well as multiple regression analysis.

RESULTS

All the CBS measures are significantly correlated to HADS-A (anxiety) and HADS-D (depression). Intensity of anxiety is most visibly linked to CBS measures of disappointment and environment (p<0.0001), while severity of depression is related to emotional involvement and general strain (p<0.0001). The factors differentiating caregiver burden measure in the subscales of general strain (p<0.0001) and social isolation (p<0.0001) include the child's age and BI, and the parent's health status; in the subscale of disappointment (p<0.0001)-the child's age, BI, GMFCS, as well as the parent's age and health status; in the subscale of emotional involvement (p=0.0007)-BI, and the parent's health status; in the subscale of environment (p=0.0002)-the child's age and BI.

CONCLUSIONS

There is a positive linear relationship between the caregiver burden measures and severity of anxiety and depression. Effort should be made to relieve caregiver burden in parents of children with CP.

摘要

目的

评估脑瘫患儿父母的照顾者负担与焦虑/抑郁症状严重程度之间的关系,并确定区分照顾者负担水平的因素。

设置

波兰东南部地区康复中心。

参与者

该研究纳入了 190 名脑瘫患儿的家长,其中 138 名女性,52 名男性。

主要和次要结果测量

照顾者负担采用照顾者负担量表(CBS)评估,焦虑和抑郁症状严重程度采用医院焦虑和抑郁量表(HADS)测量。使用脑瘫粗大运动功能分类系统(GMFCS)、巴氏指数(BI)以及聚焦儿童、家长和家庭特征的问卷来检查潜在的预测因素。分析采用 Pearson 线性相关系数和多元回归分析。

结果

所有 CBS 测量值均与 HADS-A(焦虑)和 HADS-D(抑郁)显著相关。焦虑的强度与 CBS 量表的失望和环境因素(p<0.0001)最为明显相关,而抑郁的严重程度与情感投入和一般压力(p<0.0001)相关。区分一般压力(p<0.0001)和社会孤立(p<0.0001)子量表中照顾者负担测量值的因素包括儿童年龄和 BI,以及家长健康状况;在失望子量表(p<0.0001)中-儿童年龄、BI、GMFCS 以及家长年龄和健康状况;在情感投入子量表(p=0.0007)中-BI 和家长健康状况;在环境子量表(p=0.0002)中-儿童年龄和 BI。

结论

照顾者负担测量值与焦虑和抑郁严重程度呈正线性关系。应该努力减轻脑瘫患儿家长的照顾者负担。

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