Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore.
Department of General Surgery, Singapore General Hospital, Singapore, Singapore.
PLoS One. 2022 Oct 10;17(10):e0275169. doi: 10.1371/journal.pone.0275169. eCollection 2022.
Family caregivers play a fundamental role in the care of the older blunt trauma patient. We aim to identify risk factors for negative and positive experiences of caregiving among family caregivers.
Prospective, nationwide, multi-center cohort study.
110 family caregivers of Singaporeans aged≥55 admitted for unintentional blunt trauma with an Injury Severity Score (ISS) or New Injury Severity Score (NISS)≥10 were assessed for caregiving-related negative (disturbed schedule and poor health, lack of family support, lack of finances) and positive (esteem) experiences using the modified-Caregiver Reaction Assessment (m-CRA) three months post-injury.
The association between caregiver and patient factors, and the four m-CRA domains were evaluated via linear regression.
Caregivers of retired patients and caregivers of functionally dependent patients (post-injury Barthel score <80) reported a worse experience in terms of disturbed schedule and poor health (β-coefficient 0.42 [95% Confidence Interval 0.10, 0.75], p = .01; 0.77 [0.33, 1.21], p = .001), while male caregivers and caregivers who had more people in the household reported a better experience (-0.39 [-0.73, -0.06], p = .02; -0.16 [-0.25, -0.07], p = .001). Caregivers of male patients, retired patients, and patients living in lower socioeconomic housing were more likely to experience lack of family support (0.28, [0.03, -0.53], p = .03; 0.26, [0.01, 0.52], p = .05; 0.34, [0.05, -0.66], p = .02). In the context of lack of finances, caregivers of male patients and caregivers of functionally dependent patients reported higher financial strain (0.74 [0.31, 1.17], p = .001; 0.84 [0.26, 1.43], p = .01). Finally, caregivers of male patients reported higher caregiver esteem (0.36 [0.15, 0.57], p = .001).
Negative and positive experiences of caregiving among caregivers of older blunt trauma patients are associated with pre-injury disability and certain patient and caregiver demographics. These factors should be considered when planning the post-discharge support of older blunt trauma patients.
家庭照顾者在照顾老年钝器创伤患者方面发挥着重要作用。我们旨在确定家庭照顾者在照顾方面的负面和积极体验的风险因素。
前瞻性、全国性、多中心队列研究。
110 名照顾者照顾新加坡≥55 岁的因意外钝器伤导致创伤严重程度评分（ISS）或新损伤严重程度评分（NISS）≥10 的患者。在受伤后 3 个月，使用改良照顾者反应评估（m-CRA）评估照顾者的负面（打乱日程和健康状况不佳、缺乏家庭支持、缺乏资金）和正面（尊重）体验。
通过线性回归评估照顾者和患者因素与四个 m-CRA 领域之间的关联。
退休患者的照顾者和功能依赖患者（受伤后巴氏量表评分<80）的照顾者报告在日程安排和健康状况不佳方面的体验更差（β系数 0.42[95%置信区间 0.10，0.75]，p=0.01；0.77[0.33，1.21]，p=0.001），而男性照顾者和家中人口较多的照顾者报告体验更好（-0.39[-0.73，-0.06]，p=0.02；-0.16[-0.25，-0.07]，p=0.001）。男性患者、退休患者和居住在社会经济较低住房中的患者的照顾者更有可能经历缺乏家庭支持（0.28[0.03，-0.53]，p=0.03；0.26[0.01，0.52]，p=0.05；0.34[0.05，-0.66]，p=0.02）。在缺乏资金的情况下，男性患者的照顾者和功能依赖患者的照顾者报告了更高的经济压力（0.74[0.31，1.17]，p=0.001；0.84[0.26，1.43]，p=0.01）。最后，男性患者的照顾者报告了更高的照顾者尊重（0.36[0.15，0.57]，p=0.001）。
老年钝器创伤患者照顾者的负面和积极体验与受伤前的残疾和某些患者和照顾者人口统计学特征有关。在为老年钝器创伤患者制定出院后支持计划时，应考虑这些因素。
