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荷兰针对精神障碍与躯体疾病的非正式护理提供情况:护理背景与生活质量结果的横断面调查

Informal care provision for mental versus somatic disorders in the Netherlands: a cross-sectional investigation of caregiving context and quality of life outcomes.

作者信息

Bremmers Leonarda Gm, Hakkaart-van Roijen Leona, Uyl-de Groot Carin A, Fabbricotti Isabelle N

机构信息

Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands

Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands.

出版信息

BMJ Open. 2025 Apr 25;15(4):e099565. doi: 10.1136/bmjopen-2025-099565.

Abstract

OBJECTIVES

To investigate to what extent informal caregivers of persons with a mental disorder and a somatic disorder compare, in terms of their caregiving context and quality of life measures.

DESIGN

Cross-sectional analysis of an existing panel survey dataset.

SETTING

The Netherlands, 2020.

PARTICIPANTS

Informal caregivers that provided long-term care and support to a loved one with either a somatic disorder (n=428) or mental disorder (n=176).

OUTCOME MEASURES

Self-assessed care-related, health-related and mental health-related quality of life and the caregiving context, including background and contextual factors of the informal caregiver and care recipient, caregiving strains and coping and support.

RESULTS

A significant degree of variation was present among the two caregiving groups, in terms of their caregiving context. Notably, caregivers for individuals with mental disorders had a higher subjective burden (p<0.001), care recipient comorbidity (p<0.001), need for permanent surveillance (p=0.003) and total caregiving intensity (p<0.001). Significantly worse caregiver outcomes were reported for caregivers of individuals with mental disorders for care-related (p<0.001), health-related (p=0.011) and mental health-related quality of life (p<0.001). However, the presence of a mental disorder was only found to be significantly associated with worse care-related quality of life scores (B=-4.635, p=0.002).

CONCLUSIONS

Our findings established that informal caregivers of individuals with mental disorders not only provide care and support in more burdensome caregiving contexts, but also suffer from a worse quality of life compared with informal caregivers of individuals with somatic disorders. Particularly, the impact on care-related quality of life was concerning, with the presence of a mental disorder in the care recipient found to be directly associated with a significantly worse outcome.

摘要

目的

调查患有精神障碍和躯体疾病患者的非正式照护者在照护环境和生活质量指标方面的比较程度。

设计

对现有面板调查数据集进行横断面分析。

背景

荷兰,2020年。

参与者

为患有躯体疾病(n = 428)或精神障碍(n = 176)的亲人提供长期照护和支持的非正式照护者。

结局指标

自我评估的与照护相关、与健康相关和与心理健康相关的生活质量以及照护环境,包括非正式照护者和受照护者的背景及环境因素、照护压力以及应对和支持。

结果

两个照护组在照护环境方面存在显著差异。值得注意的是,精神障碍患者的照护者主观负担更高(p < 0.001)、受照护者合并症更多(p < 0.001)、需要长期监护(p = 0.003)以及总照护强度更大(p < 0.001)。对于精神障碍患者的照护者,在与照护相关(p < 0.001)、与健康相关(p = 0.011)和与心理健康相关的生活质量方面(p < 0.001),报告的照护者结局明显更差。然而,仅发现精神障碍的存在与较差的与照护相关的生活质量得分显著相关(B = -4.635,p = 0.002)。

结论

我们的研究结果表明,与躯体疾病患者的非正式照护者相比,精神障碍患者的非正式照护者不仅在更繁重的照护环境中提供照护和支持,而且生活质量更差。特别是,对与照护相关的生活质量的影响令人担忧,发现受照护者患有精神障碍与明显更差的结局直接相关。

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