Northwestern University Feinberg, School of Medicine, Division of Cardiology, Chicago, Illinois.
Northwestern University Feinberg, School of Medicine, Division of Cardiology, Chicago, Illinois.
J Heart Lung Transplant. 2023 Sep;42(9):1197-1204. doi: 10.1016/j.healun.2023.01.015. Epub 2023 Apr 21.
Caregiving for heart failure (HF) patients is burdensome. We examined differences in caregiver burden for 3 groups of older advanced HF patients: (1) supported with mechanical circulatory support (MCS) before heart transplantation (HT MCS), (2) awaiting transplant without MCS (HT non-MCS), and (3) prior to long-term MCS and factors associated with burden.
From October 1, 2015 to December 31, 2018, we enrolled 276 caregivers for HF patients from 13 U.S. sites: 85 HT MCS, 96 HT non-MCS, and 95 prior to long-term MCS. At enrollment, caregivers completed the Oberst Caregiving Burden Scale (15 items, 2 subscales: time (range = 1-5; higher score = more time spent on task) and difficulty (range = 1-5; higher score = higher difficulty of task) and other measures. Statistical analyses included descriptive statistics, ANOVA, chi-square tests, and linear regression.
Overall, caregivers were aged 60.8 ± 9.8 years and predominantly white, female, spouses, well educated, and reported ≥1 comorbidities. Caregivers overall reported a moderate amount of time spent on tasks and slight task difficulty. Caregivers for HT non-MCS candidates reported significantly less perceived time spent on tasks than caregivers for HT MCS candidates and caregivers for patients prior to long-term MCS (2.2 ± 0.74 vs 2.4 ± 0.74 vs 2.5 ± 0.71, respectively, p = 0.02) and less perceived difficulty of tasks (1.2 ± 0.33 vs 1.4 ± 0.53 vs 1.4 ± 0.54, respectively, p = 0.01). Caregiver and patient factors were associated with caregiver burden.
Prior to HT and long-term MCS, caregiver burden was low to moderate. Caregiver factors were predominantly associated with caregiver burden. Understanding caregiver burden and factors affecting caregiver burden may enhance preoperative advanced therapies discussions and guide caregiver support.
心力衰竭（HF）患者的护理负担沉重。我们研究了 3 组老年晚期 HF 患者的护理人员负担差异：（1）在心脏移植（HT）前接受机械循环支持（MCS）的患者（HT-MCS），（2）未接受 MCS 的 HT 患者（HT 非-MCS），以及（3）长期 MCS 前患者，以及与负担相关的因素。
2015 年 10 月 1 日至 2018 年 12 月 31 日，我们从美国 13 个地点招募了 276 名 HF 患者的护理人员：85 名 HT-MCS、96 名 HT 非-MCS 和 95 名长期 MCS 前患者。在入组时，护理人员完成了 Oberst 护理人员负担量表（15 项，2 个子量表：时间（范围 1-5；分数越高表示花在任务上的时间越多）和难度（范围 1-5；分数越高表示任务难度越高）以及其他措施。统计分析包括描述性统计、方差分析、卡方检验和线性回归。
总体而言，护理人员的年龄为 60.8 ± 9.8 岁，主要为白人、女性、配偶、受过良好教育，并且报告了≥1 种合并症。护理人员总体报告了相当数量的任务时间投入和轻微的任务难度。HT 非-MCS 候选者的护理人员报告的任务时间投入明显少于 HT-MCS 候选者和长期 MCS 前患者的护理人员（分别为 2.2 ± 0.74 比 2.4 ± 0.74 比 2.5 ± 0.71，p = 0.02），并且任务难度感知较低（分别为 1.2 ± 0.33 比 1.4 ± 0.53 比 1.4 ± 0.54，p = 0.01）。护理人员和患者的因素与护理人员负担相关。
在 HT 和长期 MCS 之前，护理人员的负担为低至中度。护理人员的因素主要与护理人员的负担有关。了解护理人员的负担和影响护理人员负担的因素，可能会加强术前高级治疗的讨论并指导护理人员的支持。
