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双相 I 型障碍患者照顾者的照护负担及相关因素。

Care burden and associated factors among caregivers of patients with bipolar type I disorder.

机构信息

Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.

Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.

出版信息

BMC Prim Care. 2024 Sep 3;25(1):321. doi: 10.1186/s12875-024-02583-2.

Abstract

BACKGROUND

Family caregivers play a significant role in providing care for these people at home and need new evidence on the outcomes of their caregiving. Caregiving for people with chronic psychiatric disorders, especially Bipolar type I Disorder (BD-I), is a major challenge in the healthcare system. This study aimed to examine the relationship between caregiver burden, resilience and optimism in family caregivers of patients with BD-I.

METHODS

This study used a cross-sectional design and involved 209 family caregivers of people with BD-I by convenience sampling method. Data were collected using the Zarit Burden Inventory (ZBI), Connor-Davidson Resilience Scale (CD-RISC), and Revised Life Orientation Test (LOT-R). The participants were selected from the list of family caregivers covered by the Ibn Sina Hospital's health clinic in Mashhad, Iran. The data were analyzed using descriptive statistics and multiple regression analysis with a significance level of 0.05.

RESULTS

The average ages of the caregivers and their patients were 45.43 (13.34) and 36.7 (14.05), respectively. The average caregiver burden score was 41.92 (19.18), which was moderate (31 to 60). The predictors of caregiver burden in this study were caregiver-related factors such as optimism (p < 0.001, β = 0.25) and employment status (housewife: p = 0.038, β = 0.43; self-employed: p = 0.007, β = 0.12; retired: p < 0.001, β = 0.23), and patient-related factors such as the presence of psychotic symptoms (p < 0.001, β = 0.33), daily caregiving hours (p < 0.001, β = 0.16), history of suicide attempts (p = 0.035, β = 0.43), and alcohol consumption (p < 0.001, β = 0.85). These variables explained 58.3% of the variance in caregiver burden scores.

CONCLUSION

The study concluded that family caregivers of people with BD-I had moderate levels of caregiver burden and low resilience, influenced by various factors related to themselves and their patients. Psychological education interventions within the framework of mental health support systems are recommended to reduce caregiver burden in these people.

摘要

背景

家庭照顾者在为这些人提供居家护理方面发挥着重要作用,他们需要了解新的护理结果证据。照顾慢性精神障碍患者,特别是双相情感障碍 I 型(BD-I)患者,是医疗保健系统面临的一项重大挑战。本研究旨在探讨 BD-I 患者家庭照顾者的照顾者负担、韧性和乐观主义之间的关系。

方法

本研究采用横断面设计,通过方便抽样法招募了 209 名 BD-I 患者的家庭照顾者。使用 Zarit 照顾者负担量表(ZBI)、Connor-Davidson 韧性量表(CD-RISC)和修订后的生活取向测试(LOT-R)收集数据。参与者从伊朗马什哈德 Ibn Sina 医院健康诊所的家庭照顾者名单中选取。采用描述性统计和多元回归分析,显著性水平为 0.05。

结果

照顾者和患者的平均年龄分别为 45.43(13.34)岁和 36.7(14.05)岁。照顾者负担平均得分为 41.92(19.18),属于中度(31 至 60)水平。本研究中,照顾者负担的预测因素是照顾者相关因素,如乐观主义(p<0.001,β=0.25)和就业状况(家庭主妇:p=0.038,β=0.43;自雇人士:p=0.007,β=0.12;退休人士:p<0.001,β=0.23),以及患者相关因素,如出现精神病症状(p<0.001,β=0.33)、每日照顾时间(p<0.001,β=0.16)、自杀企图史(p=0.035,β=0.43)和饮酒(p<0.001,β=0.85)。这些变量解释了照顾者负担评分方差的 58.3%。

结论

研究得出结论,BD-I 患者的家庭照顾者存在中度的照顾者负担和较低的韧性,这受到与自身和患者相关的各种因素的影响。建议在精神卫生支持系统框架内开展心理教育干预,以减轻这些人的照顾者负担。

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