National Healthcare Group Polyclinics, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
BMC Prim Care. 2023 Jan 30;24(1):36. doi: 10.1186/s12875-023-01985-y.
Provision of care for frail older adults with multiple chronic diseases (multimorbidity) poses increasing challenge for family caregivers. Our study aims to evaluate to what extent caregiving competence, social support and positive aspects of caregiving can mitigate the effect of burden experienced by family caregivers of frail older adults with multimorbidity.
A descriptive cross-sectional study was conducted in 2 primary care clinics. Family caregivers of older adults aged 65 years and above were invited to complete interviewer-administered questionnaires. Descriptive statistics were used to describe sociodemographic and clinical data. Caregiver's burden was measured using the Zarit Burden Interview (ZBI). Mann-Whitney U test was used to compare differences in Caregiving Competence Scale (CCS), short Positive Aspects of Caregiving (S-PAC) and modified Medical Outcome Study Social support (mMOS-SS). Multivariable logistic regression was used to analyse factors associating with caregiver burden.
A total of 188 participants were recruited. 71.8% reported caregiver burden (ZBI score ≥ 10). Caregivers who perceived burden had significantly lower CCS, S-PAC and mMOS-SS scores than those who did not (10.0 vs 11.6; 26.8 vs 29.8; 24.8 vs 31.4, p < 0.001 respectively). Factors significantly associated with higher odds of perceived burden were presence of alternative caregivers (OR 3.3, 95% CI 1.09, 10.19, p = 0.04), use of community resources (OR 4.4, 95% CI 1.15, 16.83, p = 0.03) and time spent caregiving per week (OR 1.1, 95% CI 1.02, 1.10, p = 0.003).
This study found that caregivers had high perception of burden as demand in caregiving may increase. Anticipating caregiver burden and social support needs may be important part of managing these frail older adults.
为患有多种慢性疾病（共病）的体弱老年人提供护理给家庭照顾者带来了越来越大的挑战。我们的研究旨在评估照顾能力、社会支持和积极的照顾方面在多大程度上可以减轻患有多种慢性疾病的体弱老年人家庭照顾者的负担。
在 2 家初级保健诊所进行了描述性横断面研究。邀请年龄在 65 岁及以上的老年人的家庭照顾者完成访谈者管理的问卷。使用描述性统计数据描述社会人口统计学和临床数据。使用 Zarit 负担访谈 (ZBI) 衡量照顾者的负担。使用 Mann-Whitney U 检验比较照顾能力量表 (CCS)、短期积极照顾 (S-PAC) 和修改后的医疗结局研究社会支持 (mMOS-SS) 的差异。使用多变量逻辑回归分析与照顾者负担相关的因素。
共招募了 188 名参与者。71.8%的人报告有照顾负担（ZBI 得分≥10）。有负担感的照顾者的 CCS、S-PAC 和 mMOS-SS 评分明显低于没有负担感的照顾者（10.0 分比 11.6 分；26.8 分比 29.8 分；24.8 分比 31.4 分，p<0.001）。与感知负担的可能性更高相关的因素是有替代照顾者（OR 3.3，95%CI 1.09，10.19，p=0.04）、使用社区资源（OR 4.4，95%CI 1.15，16.83，p=0.03）和每周照顾时间（OR 1.1，95%CI 1.02，1.10，p=0.003）。
本研究发现，由于照顾需求可能增加，照顾者对负担的感知较高。预测照顾者的负担和社会支持需求可能是管理这些体弱老年人的重要组成部分。
