Rawi Siti Bazlina Mohd, Rafi'i Muhammad Ridzwan, Ibrahim Roszita, Ahmad Norfazilah, Sutan Rosnah, Devarajooh Cassidy
Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Raub District Health Office, Pahang State Health Department, Ministry of Health Malaysia, Raub, Pahang, Malaysia.
BMC Health Serv Res. 2025 Jun 9;25(1):822. doi: 10.1186/s12913-025-12944-x.
The chronic and debilitating nature of Type 2 Diabetes Mellitus (T2DM) not only places a significant burden on patients but also imposes high intangible costs on their caregivers. This review aimed to critically assess the intangible costs and their associated factors among caregivers of people with T2DM treated in primary healthcare settings.
A systematic search using several combinations of keywords was conducted in Scopus, WoS, and PubMed databases. The primary outcome was the score or levels of intangible costs, while the secondary outcome was the factors associated with such burden.
The review included seven cross-sectional designs (six employing a quantitative approach and one a mixed-methods approach) that adopted the Zarit Burden Interview or Zarit Caregiver Burden Scale, with four reporting a mild level, two reporting a high level, and one reporting a moderate level. Associated factors identified were characteristics of the caregiver (e.g., female, housewife, and no or low income), caregiving characteristics (longer duration and time spent in taking care of the individual with T2DM), and clinical characteristics of individuals with T2DM (i.e., presence of complication and their health status).
It was found that T2DM caregivers in primary healthcare settings experienced moderate to high levels of intangible costs. The identified vulnerable subgroup should be regularly screened for their levels of intangible costs to prevent poor outcomes in T2DM caregiving. Furthermore, the implementation of targeted support interventions for these caregivers could improve their well-being and the quality of care provided to individuals with T2DM, ultimately enhancing patient outcomes and reducing their intangible costs.
2型糖尿病（T2DM）的慢性和衰弱性不仅给患者带来了巨大负担，也给他们的照顾者带来了高昂的无形成本。本综述旨在批判性地评估在初级医疗保健环境中接受治疗的T2DM患者照顾者的无形成本及其相关因素。
在Scopus、WoS和PubMed数据库中使用多种关键词组合进行系统检索。主要结果是无形成本的得分或水平，次要结果是与此类负担相关的因素。
该综述纳入了七项采用Zarit负担访谈或Zarit照顾者负担量表的横断面设计（六项采用定量方法，一项采用混合方法），其中四项报告为轻度水平，两项报告为高水平，一项报告为中度水平。确定的相关因素包括照顾者的特征（如女性、家庭主妇、无收入或低收入）、照顾特征（照顾T2DM患者的持续时间和时间）以及T2DM患者的临床特征（即并发症的存在及其健康状况）。
研究发现，初级医疗保健环境中的T2DM照顾者经历了中度至高度的无形成本。应定期对确定的弱势群体进行无形成本水平筛查，以防止T2DM护理出现不良结果。此外，为这些照顾者实施有针对性的支持干预措施可以改善他们的幸福感以及为T2DM患者提供的护理质量，最终改善患者结局并降低他们的无形成本。
