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咳嗽刺激系统对四肢瘫痪患者照顾者的护理负担和生活质量的影响。

Impact of the cough stimulation system on the care burden and life quality of caregivers of tetraplegics.

机构信息

Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.

Department of Research, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.

出版信息

J Spinal Cord Med. 2023 Sep;46(5):778-788. doi: 10.1080/10790268.2022.2148845. Epub 2023 Apr 5.

Abstract

OBJECTIVES

To determine caregiver burden and quality of life of primary family caregivers of participants with cervical SCI before and after use of the cough stimulation system (CSS).

DESIGN

Prospective assessment at four timepoints via questionnaire responses.

SETTING

Out-patient hospital, United States.

PARTICIPANTS

15 primary family caregivers of participants with cervical SCI completed questionnaires including a respiratory care burden index ( = 15) and a commonly employed caregiver burden inventory ( = 9), before and at the 6-month, 1-year and 2-year timepoints following use of the CSS.

RESULTS

SCI participants had significant clinical improvements in terms of restoration of an effective cough and ability to manage airway secretions with use of the CSS. Restoration of expiratory muscle function with use of the CSS also resulted in less caregivers (CG) stress, greater control of their participants' breathing problems, and improvement in quality of life. Results of the caregiver burden inventory demonstrated marked reductions in caregiver burden in development items, physical health and social relationship. Overall caregiver burden fell from 43.4 ± 13.8 pre-implant to 32.4 ± 7.9 (P = 0.06), 31.7 ± 10.5 (P = 0.05), and 26.5 ± 9.3 (P = 0.01) at the 6-month, 1-year and 2-year timepoints.

CONCLUSION

Use of the CSS by cervical SCI participants results in restoration of an effective cough with significant clinical benefits. While caregiver burden is very high in primary family caregivers, they derive marked improvement in caregiver burden and quality of life with implementation of this device. ClinicalTrials.gov identifier: NCT00116337. ClinicalTrials.gov identifier: NCT01659541.

摘要

目的

在使用咳嗽刺激系统 (CSS) 前后,确定参与者主要家庭照顾者的照顾负担和生活质量。

设计

通过问卷回答在四个时间点进行前瞻性评估。

地点

美国门诊医院。

参与者

15 名参与者的主要家庭照顾者完成了问卷,包括呼吸护理负担指数 ( = 15) 和常用照顾者负担量表 ( = 9),在使用 CSS 之前和使用后 6 个月、1 年和 2 年的时间点。

结果

参与者使用 CSS 在恢复有效咳嗽和管理气道分泌物方面取得了显著的临床改善。使用 CSS 恢复呼气肌功能也减少了照顾者的压力,使他们对参与者呼吸问题的控制能力增强,并提高了生活质量。照顾者负担量表的结果显示,在发展项目、身体健康和社会关系方面,照顾者负担明显减轻。总体照顾者负担从植入前的 43.4 ± 13.8 降至 6 个月时的 32.4 ± 7.9 (P = 0.06)、1 年时的 31.7 ± 10.5 (P = 0.05)和 2 年时的 26.5 ± 9.3 (P = 0.01)。

结论

使用 CSS 可使颈脊髓损伤参与者恢复有效的咳嗽,具有显著的临床益处。尽管主要家庭照顾者的照顾负担非常高,但随着该设备的实施,他们在照顾负担和生活质量方面有了显著的改善。临床试验注册号:NCT00116337。临床试验注册号:NCT01659541。

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本文引用的文献

1
Comparison of disc and wire electrodes to restore cough via lower thoracic spinal cord stimulation.
J Spinal Cord Med. 2022 May;45(3):354-363. doi: 10.1080/10790268.2021.1936388. Epub 2021 Jul 7.
2
Effects of Lower Thoracic Spinal Cord Stimulation on Bowel Management in Individuals With Spinal Cord Injury.
Arch Phys Med Rehabil. 2021 Jun;102(6):1155-1164. doi: 10.1016/j.apmr.2020.09.394. Epub 2020 Nov 5.
5
Restoration of cough via spinal cord stimulation improves pulmonary function in tetraplegics.
J Spinal Cord Med. 2020 Sep;43(5):579-585. doi: 10.1080/10790268.2019.1699678. Epub 2019 Dec 6.
6
The effect of the burden of caregiving for people with spinal cord injury (SCI): a cross-sectional study.
Ann Ist Super Sanita. 2018 Jul-Sep;54(3):185-193. doi: 10.4415/ANN_18_03_04.
10
Case report: Minimally invasive method to activate the expiratory muscles to restore cough.
J Spinal Cord Med. 2018 Sep;41(5):562-566. doi: 10.1080/10790268.2017.1357916. Epub 2017 Oct 11.

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