Lesley Rosie, Simpson Jane, Dale Maria, Eccles Fiona, Lock Selina, Gunn Sarah
University of Leicester, Leicester, UK.
Lancaster University, Lancaster, UK.
West J Nurs Res. 2025 Jun;47(6):524-543. doi: 10.1177/01939459251327968. Epub 2025 Mar 26.
Caregivers of people with Parkinson's disease are at risk of experiencing . Understanding contributing factors is required to develop appropriate targeted interventions and support for this group. This systematic review provides an updated appraisal and synthesis of quantitative studies assessing predictors of burden among informal caregivers of people with Parkinson's.
Five electronic databases (APA PsycINFO, CINAHL, MEDLINE, Web of Science, and Cochrane Library) were systematically searched (from inception until July 2024), supplemented by hand-searches. Study quality was assessed using the cross-sectional JBI Critical Appraisal Checklist. Results were synthesized narratively.
Forty-one studies were included. Predictors of increased burden included greater impact of motor symptoms on activities of daily living, greater severity of neuropsychiatric symptoms, poorer quality of life of the person with Parkinson's, and poorer caregiver mental health. Demographics, presence of motor symptoms, motor complications, and general cognitive function did not predict burden. Evidence was inconclusive for several variables including disease stage and duration, motor symptom severity, functional ability, overall non-motor symptoms, mental health of the person with Parkinson's, and caregivers' involvement and protective factors.
Several areas for potential future intervention are indicated, although methodological weaknesses within the literature constrain the robustness of conclusions. Key areas for future research include exploring understudied variables (caregiver personality and coping style, relationship quality, and positive aspects of caregiving) that may be important predictors of burden, specifying and utilizing a more consistent definition of "informal caregiver," and recruiting younger and non-spousal caregivers and more diverse samples regarding disease severity.
帕金森病患者的照料者面临多种风险。需要了解促成因素，以便为该群体制定适当的针对性干预措施和支持。本系统评价对评估帕金森病患者非正式照料者负担预测因素的定量研究进行了更新评估和综合分析。
系统检索了五个电子数据库（美国心理学会心理学文摘数据库、护理学与健康领域数据库、医学期刊数据库、科学引文索引数据库和考克兰图书馆）（从建库至2024年7月），并辅以手工检索。使用横断面的循证卫生保健中心批判性评价清单评估研究质量。结果采用叙述性综合分析。
纳入41项研究。负担加重的预测因素包括运动症状对日常生活活动的影响更大、神经精神症状更严重、帕金森病患者的生活质量更差以及照料者心理健康状况更差。人口统计学特征、运动症状的存在、运动并发症和一般认知功能并不能预测负担。对于包括疾病阶段和病程、运动症状严重程度、功能能力、总体非运动症状、帕金森病患者的心理健康以及照料者的参与和保护因素等几个变量，证据尚无定论。
尽管文献中的方法学弱点限制了结论的稳健性，但仍指出了几个未来可能进行干预的领域。未来研究的关键领域包括探索研究较少的变量（照料者的个性和应对方式、关系质量以及照料的积极方面），这些变量可能是负担的重要预测因素；明确并采用更一致的“非正式照料者”定义；招募更年轻的非配偶照料者以及关于疾病严重程度更多样化的样本。
