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冠状动脉搭桥手术后患者的非正式配偶照料者的照料负担可预测其心理和身体健康:一项纵向临床队列研究。

Caregiver burden in informal spousal caregivers predicts psychological and physical health in patients following coronary artery bypass graft surgery: a longitudinal clinical cohort study.

作者信息

Singh Solorzano Claudio, Rowlands Hannah, Ronaldson Amy, Kidd Tara, Steptoe Andrew, Leigh Elizabeth, Jahangiri Marjan, Poole Lydia

机构信息

Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, 25125, Italy.

Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK.

出版信息

J Behav Med. 2024 Dec;47(6):1118-1126. doi: 10.1007/s10865-024-00512-3. Epub 2024 Aug 25.

Abstract

Previous research has shown that informal caregiver burden can have deleterious effects on patient recovery; however, this relationship has yet to be investigated in patients undergoing coronary artery bypass graft (CABG) surgery. This study aimed to examine the impact of the change of caregiver burden from pre- to post-surgery on patients' mental and physical health after CABG surgery. Ninety patient-caregiver dyads were assessed one month before the surgery, two months and one year after the surgery. Caregivers completed the Oberst Burden Scale to measure caregiver burden. Patients completed the Beck Depression Inventory to measure depressive symptoms, a subscale of the Hospital Anxiety and Depression Scale to measure anxiety symptoms, the Short Form-12 health assessment to measure health-related quality of life, and the Coronary Revascularisation Outcomes Questionnaire to measure surgery symptoms. Hierarchical linear regression analyses were conducted to explore the association between change in caregiver burden and post-surgery patient outcomes. A greater increase in caregiver burden from pre- to two-months post-surgery significantly predicted higher patients' depressive symptoms (β = 0.179, p = 0.010), anxiety symptoms (β = 0.114, p = 0.017), reported post-surgery symptoms (β = 0.335, p = 0.008) and reduced physical health-related quality of life (β = -0.358, p = 0.003), after controlling for a wide range of covariates. These findings were not replicated at a one-year follow-up. These results provide insights into the impact of caregiver burden on patient distress following CABG surgery, supporting the idea of psychological support interventions for caregivers to increase patients' short-term recovery outcomes.

摘要

先前的研究表明,非正式照料者的负担可能对患者康复产生有害影响;然而,这种关系尚未在接受冠状动脉搭桥术(CABG)的患者中进行研究。本研究旨在探讨手术前后照料者负担变化对CABG术后患者心理和身体健康的影响。在手术前一个月、手术后两个月和一年对90对患者-照料者进行了评估。照料者完成奥伯斯特负担量表以测量照料者负担。患者完成贝克抑郁量表以测量抑郁症状、医院焦虑抑郁量表的一个子量表以测量焦虑症状、简短健康调查问卷12项以测量与健康相关的生活质量,以及冠状动脉血运重建结果问卷以测量手术症状。进行分层线性回归分析以探讨照料者负担变化与术后患者结果之间的关联。在控制了一系列协变量后,从术前到术后两个月照料者负担的更大增加显著预测了患者更高的抑郁症状(β = 0.179,p = 0.010)、焦虑症状(β = 0.114,p = 0.017)、报告的术后症状(β = 0.335,p = 0.008)以及与身体健康相关的生活质量下降(β = -0.358,p = 0.003)。这些发现在一年随访中未得到重复。这些结果为照料者负担对CABG术后患者痛苦的影响提供了见解,支持了为照料者提供心理支持干预以提高患者短期康复结果的观点。

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