Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.
Brain Behav. 2022 Jan;12(1):e2440. doi: 10.1002/brb3.2440. Epub 2021 Dec 15.
Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID-19), as reported by informal family caregivers of individuals with chronic traumatic brain injury (TBI) or stroke living in the community, considering two different stratifications of the recipients of care (cause and injury severity).
We conducted a STROBE-compliant prospective observational study analyzing informal caregivers of individuals with stroke (IC-STROKE) or traumatic brain injury (IC-TBI). IC-STROKE and IC-TBI were assessed in-person before and during COVID-19 online, using the Head Injury Behavior Scale (HIBS). The HIBS comprises behavioral and emotional subtotals (10 items each) and a total-HIBS. Comparisons were performed using the McNemar's test, Wilcoxon signed-rank test or t-test. Recipients of care were stratified according to their injury severity using the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS).
One hundred twenty-two informal caregivers (62.3% IC-STROKE and 37.7% IC-TBI) were assessed online between June 2020 and April 2021 and compared to their own assessments performed in-person 1.74 ± 0.88 years before the COVID-19 lockdown. IC-STROKE significantly increased their level of stress during COVID-19 in five emotional items (impatience, frequent complaining, often disputes topics, mood change and overly sensitive) and in one behavioral item (overly dependent). IC-TBI stress level only increased in one behavioral item (impulsivity). By injury severity, (i) mild (14.7%) showed no significant differences in emotional and behavioral either total-HIBS (ii) moderate (28.7%) showed significant emotional differences in two items (frequent complaining and mood change) and (iii) severe (56.6%) showed significant differences in emotional (often disputes topics) and behavioral (impulsivity) items.
Our results suggest specific items in which informal caregivers could be supported considering cause or severity of the recipients of care.
即使在非大流行时期，残疾人也会经历情绪和行为障碍，这让他们和他们的亲密者感到痛苦。我们旨在比较社区中慢性创伤性脑损伤（TBI）或中风患者的非专业家庭照顾者在报告新冠病毒疾病 2019（COVID-19）之前和期间在情绪和行为方面的压力水平，同时考虑到两种不同的照顾对象分类（病因和损伤严重程度）。
我们进行了一项符合 STROBE 标准的前瞻性观察性研究，分析了中风（IC-STROKE）或创伤性脑损伤（IC-TBI）患者的非专业家庭照顾者。在 COVID-19 期间，通过在线方式使用头部损伤行为量表（HIBS）对 IC-STROKE 和 IC-TBI 进行面对面评估。HIBS 包括行为和情绪两个子量表（每个子量表 10 项）和一个总 HIBS。使用 McNemar 检验、Wilcoxon 符号秩检验或 t 检验进行比较。根据国家卫生研究院中风量表（NIHSS）和格拉斯哥昏迷量表（GCS）对照顾对象进行损伤严重程度分层。
在 2020 年 6 月至 2021 年 4 月期间，有 122 名非专业家庭照顾者（62.3%为 IC-STROKE，37.7%为 IC-TBI）接受了在线评估，并与 COVID-19 封锁前 1.74 ± 0.88 年进行的面对面评估进行了比较。IC-STROKE 在五个情绪项目（急躁、频繁抱怨、经常争论话题、情绪变化和过度敏感）和一个行为项目（过度依赖）中显著增加了 COVID-19 期间的压力水平。IC-TBI 的压力水平仅在一个行为项目（冲动）中增加。按损伤严重程度，（i）轻度（14.7%）在总 HIBS 的情绪和行为方面均无显著差异，（ii）中度（28.7%）在两个项目（频繁抱怨和情绪变化）中表现出显著的情绪差异，（iii）重度（56.6%）在情绪（经常争论话题）和行为（冲动）项目中表现出显著差异。
我们的研究结果表明，应根据照顾对象的病因或严重程度，考虑在特定项目中为非专业家庭照顾者提供支持。
