自闭症照料者照料负担的心理、行为和身体方面：一项队列研究。
Psychological, behavioural, and physical aspects of caregiver strain in autism-caregivers: a cohort study.
作者信息
Warreman Eva B, Lloyd Susan E, Nooteboom Laura A, Leenen Pieter J M, Terry Mary Beth, Hoek Hans W, van Rossum Elisabeth F C, Vermeiren Robert R J M, Ester Wietske A
机构信息
Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Endegeesterstraatweg 27, Oegstgeest 2342 AK, the Netherlands.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, United States.
出版信息
EClinicalMedicine. 2023 Sep 20;64:102211. doi: 10.1016/j.eclinm.2023.102211. eCollection 2023 Oct.
BACKGROUND
People who give care to autistic individuals (autism-caregivers) experience higher levels of caregiver strain than people who provide care for individuals with other chronic conditions (non-autism-caregivers). This places them at higher risk for psychological, behavioural and physical health concerns. The aim of this study is to delineate psychological, behavioural, and physical aspects of caregiver strain in autism-caregivers compared to non-autism-caregivers.
METHODS
We included 3354 adult caregivers from the general population in the Netherlands participating in the second assessment (January, 1, 2014-December, 31, 2017) of the Lifelines Cohort. In this cohort study, using multivariable regression adjusted for age, sex, and socioeconomic status, we analysed psychological (anxiety and depression based on a Mini International Neuropsychiatric Interview, and self-reported stress and perceived health), behavioural (questionnaire-assessed physical activity, alcohol use, and smoking), and physical aspects (body mass index, waist circumference, and leukocyte-counts) of caregiver strain in autism-caregivers (n = 722) compared with non-autism-caregivers (n = 2632).
FINDINGS
Autism-caregivers reported more stress (OR 3.61, 95% CI 2.60-4.99). Both anxiety (OR 1.85, 95% CI 1.37-2.49) and depressive disorders (OR 1.83, 95% CI 1.17-2.86) were more common in autism-caregivers than in non-autism-caregivers. Perceived health, physical activity, alcohol use, and smoking were not different between autism- and non-autism-caregivers. In autism-caregivers, lymphocyte- and monocyte-counts were lower than in non-autism-caregivers.
INTERPRETATION
In this large cohort, autism-caregivers had worse psychological health than non-autism-caregivers. Moreover, autism-caregiving might be associated with an altered immune balance. These findings underline the higher caregiver strain in autism-caregivers compared to other caregivers. This calls for increased support to autism-caregivers.
FUNDING
Lifelines has been funded by the Dutch government.
背景
与照顾其他慢性病患者的人（非自闭症照顾者）相比，照顾自闭症患者的人（自闭症照顾者）承受着更高程度的照顾负担。这使他们面临更高的心理、行为和身体健康问题风险。本研究的目的是描绘出自闭症照顾者与非自闭症照顾者在照顾负担方面的心理、行为和身体状况。
方法
我们纳入了来自荷兰普通人群的3354名成年照顾者，他们参与了生命线队列研究的第二次评估（2014年1月1日至2017年12月31日）。在这项队列研究中，我们使用对年龄、性别和社会经济地位进行调整的多变量回归分析，比较了自闭症照顾者（n = 722）与非自闭症照顾者（n = 2632）在照顾负担方面的心理状况（基于迷你国际神经精神访谈的焦虑和抑郁，以及自我报告的压力和健康感知）、行为状况（问卷评估的身体活动、饮酒和吸烟情况）和身体状况（体重指数、腰围和白细胞计数）。
研究结果
自闭症照顾者报告的压力更大（比值比3.61，95%置信区间2.60 - 4.99）。自闭症照顾者中焦虑（比值比1.85，95%置信区间1.37 - 2.49）和抑郁症（比值比1.83，95%置信区间1.17 - 2.86）都比非自闭症照顾者更常见。自闭症照顾者和非自闭症照顾者在健康感知、身体活动、饮酒和吸烟方面没有差异。在自闭症照顾者中，淋巴细胞和单核细胞计数低于非自闭症照顾者。
解读
在这个大型队列中，自闭症照顾者的心理健康状况比非自闭症照顾者更差。此外，照顾自闭症患者可能与免疫平衡改变有关。这些发现强调了与其他照顾者相比，自闭症照顾者承受着更高的照顾负担。这需要加强对自闭症照顾者的支持。
资金来源
生命线队列研究由荷兰政府资助。
Zotero 插件