REFiT Bcn Research Group, Parc Sanitari Pere Virgili and Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.
Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
PLoS One. 2024 Oct 4;19(10):e0307930. doi: 10.1371/journal.pone.0307930. eCollection 2024.
We aimed to describe the intensity of care and its consequences on informal caregivers of stroke survivors according to the degree of care receivers' functional dependence for activities of daily living; and to identify the factors associated with caregivers' care-related quality of life.
Cross-sectional analysis of prospective data collected in a cost-utility study alongside the RACECAT trial in Catalonia (Spain). One-hundred and thirty-two care receiver-caregiver pairs were interviewed six months after stroke. Functional dependence for activities of daily living was measured with the Barthel index. We assessed caregivers care-related quality of life with the CarerQoL, which measures seven dimensions of subjective burden (CarerQoL-7D) and a happiness score (CarerQoL-VAS). We evaluated the association between characteristics of informal caregivers, characteristics of care receivers, and intensity of care, and the caregiver's care-related quality of life (subjective burden and happiness) in a hypothesized model using a structural equation model.
Of the 132 caregivers, 74,2% were women with an average age of 59.4 ± 12.5 years. The 56.8% of them were spouses. The care intensity ranged from a mean of 24h/week for mild to 40h/week for severe dependence. Most caregivers (76.3%) were satisfied with their task, regardless of dependence, but showed increasing problems in caring for severely dependent persons. Being a woman (coeff. -0.23; 95%CI: -0.40, -0.07), spending more time in care tasks (coeff -0.37; -0.53, -0.21) and care receiver need of constant supervision (coeff 0.31; -0.47, -0.14) were associated with higher burden of care, irrespective of the degree of dependence. Caregiver burden (coeff 0.46; 0.30-0.61) and care receiver anxiety or depression (coeff -0.19; -0.34, -0.03) were associated with lower caregiver happiness.
The findings suggest the importance of developing mainly two types of support interventions for caregivers: respite and psychosocial support. Especially for women with high caring burden and/or caring for persons with high levels of anxiety or depression.
根据日常生活活动自理能力依赖程度,描述脑卒中幸存者的照顾者的照顾强度及其后果;并确定与照顾者的照顾相关生活质量相关的因素。
这是一项针对前瞻性数据的横断面分析,数据来自西班牙加泰罗尼亚的 RACECAT 试验中的成本效益研究。在脑卒中后 6 个月,对 132 对照顾者和被照顾者进行了访谈。日常生活活动自理能力依赖程度采用巴氏量表(Barthel index)进行评估。我们使用照顾者相关生活质量量表(CarerQoL)来评估照顾者的照顾相关生活质量,该量表测量了七个主观负担维度(CarerQoL-7D)和一个幸福感评分(CarerQoL-VAS)。我们在假设模型中使用结构方程模型评估了非正式照顾者的特征、被照顾者的特征、照顾强度与照顾者的照顾相关生活质量(主观负担和幸福感)之间的关系。
在 132 名照顾者中,有 74.2%是女性,平均年龄为 59.4±12.5 岁。其中 56.8%是配偶。照顾强度范围从轻度依赖者的平均每周 24 小时到重度依赖者的每周 40 小时。无论依赖程度如何,大多数照顾者(76.3%)对自己的任务感到满意,但对照顾重度依赖者的问题越来越多。女性(系数-0.23;95%CI:-0.40,-0.07)、在照顾任务上花费更多时间(系数-0.37;-0.53,-0.21)和照顾者需要持续监督(系数 0.31;-0.47,-0.14)与更高的照顾负担相关,而与依赖程度无关。照顾者负担(系数 0.46;0.30-0.61)和照顾者焦虑或抑郁(系数-0.19;-0.34,-0.03)与照顾者的幸福感较低相关。
研究结果表明,为照顾者开发两种主要的支持干预措施非常重要:休息和心理社会支持。特别是对于高照顾负担和/或照顾高焦虑或抑郁水平的人的女性。