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南非一家精神科三级医院中,精神分裂症患者家庭照料者的照料负担及其社会人口学决定因素。

Caregiver burden and its sociodemographic determinants in family caregivers of patients with schizophrenia attending a psychiatric tertiary hospital in South Africa.

作者信息

Onyia Chioma O, Lethole Julia S, Olorunfemi Gbenga, Ngene Nnabuike C

机构信息

Department of Psychiatry, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.

Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

S Afr J Psychiatr. 2024 Jun 21;30:2252. doi: 10.4102/sajpsychiatry.v30i0.2252. eCollection 2024.

Abstract

BACKGROUND

Chronic mental illnesses such as schizophrenia affect patients' functioning, making caregiving necessary although burdensome.

AIM

This study aimed to determine caregiver burden and its sociodemographic determinants in family caregivers of patients with schizophrenia attending a Psychiatric Outpatient Department (POD).

SETTING

Tertiary hospital in Northern Pretoria, South Africa.

METHODS

In this cross-sectional study conducted over 3 months, 300 consecutive family caregivers who attended the POD were administered a 22-item Zarit Burden Interview (ZBI-22), which has a score of 0-88, with higher values indicating more burden. Their sociodemographic characteristics were ascertained. Linear and ordinal logistic regression analyses were performed to identify determinants or predictors of total and severe burdens, respectively.

RESULTS

Most caregivers were aged 46.0 ± 14 years, females (62%), parents (39%), of low-income status (93.7%), had secondary education (70%), resided with the patient (87%), and helped with all troublesome activities (95.3%). The median ZBI-22 score was 19.0 (interquartile range: 13.0-30.5). The determinants of both total and severe burdens were: caregiver age ≥ 50 years adjusted odds ratio (aOR): 2.55, confidence interval (CI): 1.49-4.36; residential area farther away from the hospital aOR: 1.76, CI: 1.3-2.99; increasing months of caregiving aOR: 1.0, CI: 1.001-1.009, = 0.006; and not having another family member that needs care aOR: 0.43, CI: 0.24-0.78.

CONCLUSION

Having mental healthcare facilities close to residential areas and assisting caregivers aged ≥ 50 years who have multiple family members who need care may alleviate the burden.

CONTRIBUTION

Predicting total and severe caregiver burdens contemporaneously is effective for identifying potential burden interventions.

摘要

背景

精神分裂症等慢性精神疾病会影响患者的功能,这使得提供照护成为必要之举,尽管负担沉重。

目的

本研究旨在确定在精神科门诊部就诊的精神分裂症患者的家庭照护者的照护负担及其社会人口学决定因素。

地点

南非比勒陀利亚北部的一家三级医院。

方法

在这项为期3个月的横断面研究中,对连续300名到精神科门诊部就诊的家庭照护者进行了一项包含22个条目的 Zarit 负担访谈量表(ZBI - 22)测评,该量表得分范围为0 - 88分,分数越高表明负担越重。确定了他们的社会人口学特征。分别进行线性和有序逻辑回归分析,以确定总体负担和重度负担的决定因素或预测因素。

结果

大多数照护者年龄为46.0 ± 14岁,女性(62%),父母(39%),低收入状态(93.7%),接受过中等教育(70%),与患者同住(87%),并协助处理所有麻烦事务(95.3%)。ZBI - 22量表的中位数得分为19.0(四分位间距:13.0 - 30.5)。总体负担和重度负担的决定因素包括:照护者年龄≥50岁,调整后的优势比(aOR):2.55,置信区间(CI):1.49 - 4.36;居住地区离医院较远,aOR:1.76,CI:1.3 - 2.99;照护月数增加,aOR:1.0,CI:1.001 - 1.009,P = 0.006;以及没有其他需要照护的家庭成员,aOR:0.43,CI:0.24 - 0.78。

结论

在居住地区附近设立精神卫生保健设施,并为年龄≥50岁且有多个需要照护家庭成员的照护者提供帮助,可能会减轻负担。

贡献

同时预测照护者的总体负担和重度负担对于确定潜在的减轻负担干预措施是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/713c/11219544/794f647b0139/SAJPsy-30-2252-g001.jpg

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