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患者功能障碍与照顾者负担之间的关系:重度慢性阻塞性肺疾病患者是否存在临界点?

Relationship between patient functionality impairment and caregiver burden: is there a cut off point for the severe COPD patient?

作者信息

Granados-Santiago María, Romero-Fernández Ramón, Calvache-Mateo Andrés, Heredia-Ciuro Alejandro, Martin-Nuñez Javier, López-López Laura, Valenza Marie Carmen

机构信息

Department of Nursing. Faculty of Health Sciences, University of Granada, Granada, Spain.

Department of Physiotherapy. Faculty of Health Sciences, University of Granada, Granada, Spain.

出版信息

Expert Rev Respir Med. 2023 Mar;17(3):247-253. doi: 10.1080/17476348.2023.2190887. Epub 2023 Mar 20.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) patients experience a progressive limitation of their functionality accompanying their clinical evolution. Concretely, severe COPD patients usually require the figure of a caregiver. Caregiver burden has yet to be explored in other similar chronic diseases. The objective is to propose a cutoff point in different functional impairment aspects, to predict the presence of caregiver burden.

METHODS

Severe COPD patients were divided into two groups according to the caregiver burden, measured with the Zarit Burden Interview (ZBI). The patients were assessed with the London Chest Activity of Daily Living (LCADL) scale, the Functional Independence Measure (FIM), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0).

RESULTS

70 COPD patients and their caregivers were included in this cross-sectional study. The ROC curve indicated a cutoff point of 19 in the LCADL scale (AUC = 0.722). Dependence in daily life activities had a cutoff point of 123 in the FIM (AUC = 0.776). Social participation in activities of daily living had a cutoff point of 37 in the WHODAS 2.0 (AUC = 0.739).

CONCLUSION

Dyspnea related to functional status, dependence in daily life activities, and social participation in activities of daily living of severe COPD patients can predict caretaker burden.

摘要

背景

慢性阻塞性肺疾病(COPD)患者在临床病情发展过程中,其功能会逐渐受限。具体而言,重度COPD患者通常需要有护理人员。在其他类似的慢性疾病中,护理人员负担问题尚未得到研究。目的是提出不同功能损害方面的临界值,以预测护理人员负担的存在。

方法

根据用Zarit护理负担访谈量表(ZBI)测量的护理人员负担,将重度COPD患者分为两组。采用伦敦胸部日常生活活动量表(LCADL)、功能独立性测量量表(FIM)和世界卫生组织残疾评定量表2.0(WHODAS 2.0)对患者进行评估。

结果

本横断面研究纳入了70例COPD患者及其护理人员。ROC曲线显示,LCADL量表的临界值为19(曲线下面积[AUC]=0.722)。日常生活活动依赖性方面,FIM量表的临界值为123(AUC=0.776)。日常生活活动社会参与度方面,WHODAS 2.0量表的临界值为37(AUC=0.739)。

结论

重度COPD患者与功能状态相关的呼吸困难、日常生活活动依赖性及日常生活活动社会参与度可预测护理人员负担。

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