更多的全科医生接触和较差的健康状况非正式照顾者与低社会经济地位在德国:基于人口的 DEGS1 和横断面 GPCare-1 研究的结果。
More GP contacts and poorer health of informal caregivers with low socioeconomic status in Germany: results from the population-based DEGS1 and the cross-sectional GPCare-1 study.
机构信息
Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany.
出版信息
BMJ Open. 2021 Dec 30;11(12):e053146. doi: 10.1136/bmjopen-2021-053146.
OBJECTIVES
Informal caregivers are known to have poorer mental health. Risk factors for caregiver burden include low education, female gender, cohabitation with the care recipient and lack of resources. General practitioners (GPs) have an important role in supporting caregivers. Drawing on data from two surveys, associations between caregivers' socioeconomic status (SES), psychophysical health and GP contacts are analysed.
DESIGN
Cross-sectional study. The study draws on data from two surveys (German Health Interview and Examination Survey for Adults, DEGS1 and General Practice Care-1, GPCare-1).
SETTING
Germany.
PARTICIPANTS
DEGS1: German general population (18+ years) n=7987. GPCare-1: general practice patients (18+ years) n=813.
PRIMARY OUTCOME
Psychophysical health, GP contacts and communication.
METHODS
Using representative DEGS1 data, the prevalence of informal caregivers, caregivers' burden, chronic stress, various health conditions and frequency of GP contacts were evaluated stratified by SES. Data from the GPCare-1 study addressed caregivers' experiences and communication preferences with GPs.
RESULTS
In the DEGS1, the prevalence of caregivers was 6.5%. Compared with non-caregivers, caregivers scored significantly higher for chronic stress (15.45 vs 11.90), self-reported poor health (37.6% vs 23.7%) and GP visits last year (3.95 vs 3.11), while lifestyle and chronic diseases were similar. Compared with caregivers with medium/high SES, those with low SES had a significantly lower prevalence of high/medium caregiver burden (47.9% vs 67.7%) but poorer self-reported health (56.9% vs 33.0%), while other characteristics did not differ. In the GPCare-1 study, the prevalence of caregivers was 12.6%. The majority of them felt that their GP takes their problems seriously (63.6%) without difference by SES.
CONCLUSION
Caregivers with low SES constitute an especially high-risk group for psychological strain, requiring special GP attention to support their needs.
目的
众所周知，非正式照顾者的心理健康状况较差。照顾者负担的风险因素包括教育程度低、女性、与被照顾者同住以及缺乏资源。全科医生（GP）在支持照顾者方面发挥着重要作用。本研究利用两项调查的数据，分析了照顾者的社会经济地位（SES）、心理生理健康和与 GP 的接触之间的关联。
设计
横断面研究。本研究利用两项调查（德国成年人健康访谈和体检调查，DEGS1 和一般实践护理-1，GPCare-1）的数据。
地点
德国。
参与者
DEGS1：德国普通人群（18 岁及以上）n=7987。GPCare-1：普通实践患者（18 岁及以上）n=813。
主要结果
心理生理健康、与 GP 的接触和沟通。
方法
利用具有代表性的 DEGS1 数据，按 SES 分层评估了非正式照顾者的流行率、照顾者负担、慢性压力、各种健康状况和与 GP 的接触频率。来自 GPCare-1 研究的数据涉及照顾者与 GP 的沟通偏好和体验。
结果
在 DEGS1 中，照顾者的比例为 6.5%。与非照顾者相比，照顾者的慢性压力评分显著更高（15.45 对 11.90），自我报告的健康状况较差（37.6% 对 23.7%），去年与 GP 的就诊次数也更多（3.95 对 3.11），而生活方式和慢性疾病相似。与 SES 中/高的照顾者相比，SES 低的照顾者高/中程度的照顾者负担的患病率显著较低（47.9% 对 67.7%），但自我报告的健康状况较差（56.9% 对 33.0%），而其他特征则没有差异。在 GPCare-1 研究中，照顾者的比例为 12.6%。他们中的大多数人认为他们的 GP 认真对待他们的问题（63.6%）， SES 之间没有差异。
结论
SES 低的照顾者构成了心理压力的高危人群，需要特别关注 GP 以满足他们的需求。
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