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中风后照顾者负担:对波兰中风患者照顾者的10年随访研究

Caregiver burden after stroke: a 10-year follow-up study of Polish caregivers for stroke patients.

作者信息

Jaracz Krystyna, Grabowska-Fudala Barbara, Jaracz Jan, Moczko Jerzy, Kleka Paweł, Pawlicka Aleksandra, Górna Krystyna

机构信息

Department of Neurological Nursing, Poznan University of Medical Sciences, 2 A, Rokietnicka Str, 60-806, Poznań, Poland.

Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznań, Poland.

出版信息

BMC Nurs. 2024 Aug 26;23(1):589. doi: 10.1186/s12912-024-02251-x.

Abstract

BACKGROUND

A long-term assessment of stroke outcomes from the perspectives of patients and their caregivers is important for optimising long-term post-stroke care. The extended effects of stroke caregiving, particularly caregiver burden beyond 5 years since stroke, remain to be determined. Hence, this study aimed to determine caregiver burden at 10 years after stroke, compare the burden severity at 10 years with its levels at 5 years and 6 months after stroke, and identify predictors of the burden severity at 10 years post-stroke.

METHODS

A longitudinal follow-up study including a group of first-ever stroke patients/informal continuous caregivers pairs was followed for 10 years and interviewed face-to face at their home setting. Caregiver burden was evaluated with the Caregiver Burden Scale. Potential predictors were examined using standardised measures and identified by applying the Classification and Regression Tree.

RESULTS

A total of 40 caregiver/patient pairs participated in the study. At 10 years, 47.5% of the caregivers experienced a considerable burden. This was more than after 5 years (17.5%) and comparable to that after 6 months (37.5%), p < 0.003. Longer time spent caregiving, caregivers' weaker sense of coherence, more severe stroke, and caregivers' anxiety were the independent predictors of considerable burden 10 years after stroke.

CONCLUSIONS

Caregivers' burden in the late chronic post-stroke phase is a significant problem, as nearly half of the caregivers experience a substantial burden. This problem mainly concerns individuals who spend at least 7 h daily caregiving and have a lower Sense of Coherence. The long-term evaluation of stroke consequences reported by stroke patients and their caregivers can be an important source of information for healthcare professionals in order to optimise the care and support they provide at various stages of life after stroke.

摘要

背景

从患者及其照料者的角度对卒中结局进行长期评估对于优化卒中后长期护理至关重要。卒中照料的长期影响,尤其是卒中后5年以上的照料者负担,仍有待确定。因此,本研究旨在确定卒中后10年时照料者的负担,比较10年时的负担严重程度与其在卒中后5年和6个月时的水平,并确定卒中后10年负担严重程度的预测因素。

方法

一项纵向随访研究纳入了一组首次发生卒中的患者/非正式持续照料者对,随访10年,并在其家中进行面对面访谈。使用照料者负担量表评估照料者负担。使用标准化测量方法检查潜在预测因素,并通过应用分类回归树进行识别。

结果

共有40对照料者/患者参与了本研究。在10年时,47.5%的照料者经历了相当大的负担。这一比例高于5年后(17.5%),与6个月后(37.5%)相当,p<0.003。照料时间较长、照料者的连贯感较弱、卒中更严重以及照料者焦虑是卒中后10年相当大负担的独立预测因素。

结论

卒中后慢性晚期照料者的负担是一个重大问题,因为近一半的照料者经历了沉重负担。这个问题主要涉及那些每天至少花费7小时进行照料且连贯感较低的个体。卒中患者及其照料者报告的卒中后果的长期评估可以为医疗保健专业人员提供重要的信息来源,以便优化他们在卒中后不同生命阶段提供的护理和支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa75/11346017/c3cdc908fe15/12912_2024_2251_Fig1_HTML.jpg

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