Ching Carmen, Wiebe Nicole, Zhu Julie
Department of Medicine, McGill University, Montreal, Quebec, Canada.
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Can Liver J. 2025 Apr 14;8(2):355-367. doi: 10.3138/canlivj-2025-0013. eCollection 2025 May.
Cirrhosis is a major cause of morbidity and mortality. Caregivers of cirrhotic patients provide significant support related to disease manifestations and complications. This scoping review aims to identify the prevalence of caregiver burden among patients with cirrhosis and to identify patient and caregiver factors that predict caregiver burden in patients with cirrhosis.
A literature search was conducted using MEDLINE, EMBASE, CINAHL, and Web of Science to identify studies for inclusion. Screening and data extraction were performed using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia).
604 articles were identified, and 15 were included in the review. Caregivers were predominantly female and spouses of the patient. The average age of patients varied between 41.2 and 57.2 (SD 10.3 to 12.5). The most common cirrhotic aetiologies were alcohol-related, viral hepatitis-related, and metabolic-related aetiologies. The most used survey tools to assess burden were the Zarit Burden Interview (ZBI) score, Short Form-36 Health Survey (SF-36), and Beck Depression/Anxiety Inventory (BDI or BAI). Patient factors contributing toward caregiver burden included prior hepatic encephalopathy (HE), alcohol use, and high Model for End-Stage Liver Disease (MELD) scores. Caregiver factors that contribute toward caregiver burden included poor perceived social supports, low and disrupted income, and being the spouse of the patient.
Several patient and caregiver factors contribute to caregiver burden, and greater levels of burden may affect multiple aspects of a caregiver's life, potentially worsening patient outcomes. A multidisciplinary approach is critical to alleviate caregiver burnout and optimize the overall care for a patient with cirrhosis.
肝硬化是发病和死亡的主要原因。肝硬化患者的照料者为疾病表现和并发症提供了重要支持。本综述旨在确定肝硬化患者照料者负担的患病率，并确定预测肝硬化患者照料者负担的患者和照料者因素。
使用MEDLINE、EMBASE、CINAHL和Web of Science进行文献检索，以确定纳入研究。使用Covidence系统评价软件（澳大利亚墨尔本Veritas Health Innovation公司）进行筛选和数据提取。
共识别出604篇文章，15篇纳入综述。照料者主要为女性，且是患者的配偶。患者的平均年龄在41.2至57.2岁之间（标准差为10.3至12.5）。最常见的肝硬化病因是酒精相关、病毒性肝炎相关和代谢相关病因。评估负担最常用的调查工具是Zarit负担访谈（ZBI）评分、简明健康调查量表（SF-36）和贝克抑郁/焦虑量表（BDI或BAI）。导致照料者负担的患者因素包括既往肝性脑病（HE）、饮酒和终末期肝病模型（MELD）评分高。导致照料者负担的照料者因素包括社会支持感差、收入低且不稳定以及是患者的配偶。
患者和照料者的多个因素会导致照料者负担加重，而更高程度的负担可能会影响照料者生活的多个方面，可能使患者的预后恶化。多学科方法对于减轻照料者倦怠和优化肝硬化患者的整体护理至关重要。
