Elzeneini Mohammed, Osman Alfaroug, Bright Khadija, Yang Shuang, Guo Yi, Jeng Eric, Shah Khanjan B
Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA.
Palliat Med Rep. 2023 Feb 24;4(1):56-58. doi: 10.1089/pmr.2022.0064. eCollection 2023.
Little is known about the impact of symptomatic aortic stenosis and subsequent transcatheter aortic valve replacement (TAVR) on stress and health for the caregiver. In this prospective cohort study, we measured caregiver stress before and after TAVR.
We interviewed 34 primary caregivers for patients undergoing outpatient TAVR at an academic institution. Caregiver stress was measured using the Kingston Caregiver Stress Scale (KCSS) and the Caregiver Self-Assessment Questionnaire (CSAQ) before TAVR and at one and six months after. Mean scores were compared pre- and post-TAVR using the Wilcoxon signed-rank test.
There was significant improvement in KCSS caregiver stress at one month that was sustained at six months post-TAVR (mean change -1.91 ± 2.50 for six months, -value 0.01). This was primarily driven by improvement in caregiving issues rather than family or financial issues. There was also significant improvement in CSAQ self-assessed health/illness at one and six months (mean change -2.78 ± 4.01 for six months, -value 0.016).
Our findings support further investigation of caregiver outcomes in shared decision making before TAVR.
关于有症状的主动脉瓣狭窄及随后的经导管主动脉瓣置换术（TAVR）对照顾者压力和健康的影响，目前所知甚少。在这项前瞻性队列研究中，我们测量了TAVR前后照顾者的压力。
我们对一家学术机构中接受门诊TAVR治疗患者的34名主要照顾者进行了访谈。在TAVR前、术后1个月和6个月，使用金斯顿照顾者压力量表（KCSS）和照顾者自我评估问卷（CSAQ）测量照顾者的压力。使用Wilcoxon符号秩检验比较TAVR前后的平均得分。
术后1个月KCSS照顾者压力有显著改善，并在TAVR后6个月持续存在（6个月时平均变化为-1.91±2.50，P值为0.01）。这主要是由照顾问题的改善而非家庭或财务问题驱动的。在术后1个月和6个月，CSAQ自我评估的健康/疾病状况也有显著改善（6个月时平均变化为-2.78±4.01，P值为0.016）。
我们的研究结果支持在TAVR前进一步研究共同决策中照顾者的结局。
