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[关键照料者的医学社会概况。他/她是隐匿性患者吗?]

[Medicosocial profile of the crucial caregiver. Is he/she an occult patient?].

作者信息

Rubio Montañés M L, Sánchez Ibáñez A, Ibáñez Estella J A, Galve Royo F, Martí Talens N, Mariscal Bernal J

机构信息

Unidad Docente de Medicina de Familia y Communitaria de Teruel.

出版信息

Aten Primaria. 1995 Sep 15;16(4):181-6.

PMID:7548659
Abstract

OBJECTIVE

To determine the prevalence of physical pathology (morbidity felt) and psychological unease (anxiety-depression) in crucial carers for disabled patients, and so establish a profile of them.

DESIGN

An observational study. Analysis of two historical cohorts.

SETTING

Primary care. Urban health centre.

PATIENTS

The exposed cohort was made up of 54 carers for disabled patients, chosen at random from the records at our Centre. The non-exposed cohort (n = 54), matched for age, gender and educational level, was chosen at random from the consulting rooms.

MEASUREMENTS AND MAIN RESULTS

By means of a questionnaire, descriptive variables were collected, i.e. the morbidity felt, consumption of medicine, psychological unease (Goldberg's anxiety-depression scale), perception of social support (modified Duke Unl), index of the effort of the carer (IEC) and the profile of the person being cared for. The "typical" carer was a 57-year old woman (CI 95: 54-61), with a low educational level, daughter or wife of the disabled person, who received external help in few cases (11%). Problems of health referred to by carers (Arthralgia, migraines, asthenia, feeling depressed and insomnia), are more frequent (p < 0.001) than in non-carers. 75% took some medication, as against 45% of non-carers (p < 0.001). 83% displayed anxiety and 63% depression, against 36 and 37%, respectively, in the non-exposed cohort. A high IEC implied greater risk of anxiety (p < 0.05) and depression (p < 0.001).

CONCLUSIONS

The crucial carer has a greater prevalence of physical and psychological morbidity. A high IEC and a perception of low social support create the conditions for higher anxiety and depression. Caring for the carer needs to be integrated into care for the disabled patient.

摘要

目的

确定残疾患者主要照料者的身体病理状况(感觉到的发病率)和心理不安(焦虑 - 抑郁)的患病率,从而建立他们的概况。

设计

一项观察性研究。对两个历史队列进行分析。

地点

初级保健。城市健康中心。

患者

暴露队列由54名残疾患者的照料者组成,从我们中心的记录中随机选取。非暴露队列(n = 54),在年龄、性别和教育水平上进行匹配,从诊室中随机选取。

测量和主要结果

通过问卷调查收集描述性变量,即感觉到的发病率、药物消费、心理不安(戈德堡焦虑 - 抑郁量表)、社会支持感知(改良的杜克大学量表)、照料者努力指数(IEC)以及被照料者的概况。“典型”照料者是一名57岁的女性(95%置信区间:54 - 61岁),教育水平低,是残疾人的女儿或妻子,很少有外部帮助(11%)。照料者提及的健康问题(关节痛、偏头痛、乏力、感到抑郁和失眠)比非照料者更频繁(p < 0.001)。75%的人服用某种药物,而非照料者为45%(p < 0.001)。83%表现出焦虑,63%表现出抑郁,而非暴露队列中分别为36%和37%。高IEC意味着焦虑风险更高(p < 0.05)和抑郁风险更高(p < 0.001)。

结论

主要照料者身体和心理疾病的患病率更高。高IEC和低社会支持感知为更高的焦虑和抑郁创造了条件。对照料者的关怀需要纳入对残疾患者的护理中。

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