School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Communication Disorders and Sciences Program, University of Oregon, Eugene.
Am J Speech Lang Pathol. 2022 Jan 18;31(1):486-501. doi: 10.1044/2021_AJSLP-21-00249. Epub 2021 Dec 28.
A previous review suggested that dysphagia is negatively associated with burden in caregivers of community-dwelling older adults. Other literature suggests similar patterns of burden may be found across adult patient populations. The current study, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted to determine the impact of dysphagia on caregivers of adults, regardless of etiology.
Five electronic databases were searched using terms based on a review by Namasivayam-MacDonald and Shune (2018) but included all adults rather than only older adults. Searches were limited to English-language empirical studies discussing caregiver burden, included caregivers of adult care recipients, had some care recipients with dysphagia, did not include palliative care, and published in a peer-reviewed journal.
The search yielded 1,112 unique abstracts, of which 17 were accepted. Across studies, caregiver burden was found to increase due to dysphagia in care recipients. Commonly reported dysphagia-related causes of burden included changes in meal preparation, disruption in lifestyle, effects on social life, lack of support, insertion of feeding tubes, and fear of aspiration. In general, dysphagia-related caregiver burden was a common experience across caregivers, regardless of patient population, caregiver age, and relationship between caregiver and care recipient. Meta-analyses suggest 71% of caregivers of adults with dysphagia experience some degree of burden.
These findings support that dysphagia negatively impacts caregiver burden and suggests sources of burden that clinicians can address within dysphagia management to support caregivers. However, more research is needed to better delineate sources of burden, especially those specific to various dysphagia etiologies, to better meet the needs of our patients.
先前的一项综述表明，社区居住的老年人的照料者的吞咽困难与负担呈负相关。其他文献表明，类似的负担模式可能存在于成年患者群体中。本研究遵循系统评价和荟萃分析的首选报告项目指南进行，旨在确定吞咽困难对成年患者的照料者的影响，无论病因如何。
使用基于 Namasivayam-MacDonald 和 Shune（2018 年）综述的术语，对五个电子数据库进行了搜索，但包括所有成年人，而不仅仅是老年人。搜索仅限于讨论照料者负担的英文实证研究，包括成年照护接受者的照料者，有一些照护接受者有吞咽困难，不包括姑息治疗，并且发表在同行评议的期刊上。
搜索产生了 1112 篇独特的摘要，其中 17 篇被接受。在研究中，发现由于照护接受者的吞咽困难，照料者的负担增加了。常见的与吞咽困难相关的负担原因包括膳食准备的改变、生活方式的中断、对社交生活的影响、缺乏支持、插入喂养管以及对吸入的恐惧。一般来说，无论患者群体、照料者年龄以及照料者和照护接受者之间的关系如何，与吞咽困难相关的照料者负担是所有照料者的常见经历。荟萃分析表明，71%的有吞咽困难的成年患者的照料者经历了某种程度的负担。
这些发现支持吞咽困难对照料者负担有负面影响，并表明临床医生可以在吞咽困难管理中解决负担的来源，以支持照料者。然而，需要更多的研究来更好地阐明负担的来源，特别是那些与各种吞咽困难病因相关的来源，以更好地满足患者的需求。
