O'Reilly F, Finnan F, Allwright S, Smith G D, Ben-Shlomo Y
Department of Community Health and General Practice, Trinity College, Dublin.
Br J Gen Pract. 1996 Sep;46(410):507-12.
Several previous studies have examined the health of carers, but they have usually focused on elderly subjects and have often not had representative control samples.
To determine whether caring for a partner with Parkinson's disease is associated with a worsening social, psychological and physical well-being than people with partners who do not suffer with Parkinson's disease.
One hundred and fifty-four carer spouses of subjects with Parkinson's disease, and 124 non-carer spouses of randomly selected population controls recruited from a national case-control study of early-onset Parkinson's disease in the Republic of Ireland, between 1992-1994, were studied. Outcome was measured along three dimensions: social functioning, assessed by the frequency of social contacts, outings and holidays; psychological well-being, measured by the General Health Questionnaire; and physical health, measured by the career's use of medical services, medications and episodes of chronic illness.
Carer spouses were less likely to get out of the house once a week at least (odds ratio 1.79, 95% confidence intervals 1.00-3.20) or to have had a holiday in the last year (odds ratio 1.71, 95% confidence intervals 1.01-2.90). Contact with friends and neighbours decreased with increasing care provision. For spouses providing a lot of care, there was an almost fivefold increase in psychiatric morbidity (odds ratio 4.86, 95% confidence intervals 1.5-15.9) after adjusting for other variables. Most of the medical outcomes were less favourable among carers, but only the use of tranquilizers (odds ratio 3.73, 95% confidence intervals 1.18-11.8) and episodes of chronic illness (odds ratio 2.96, 95% confidence intervals 1.27-6.94) were significant.
Overall, career spouses have slightly worse social, psychological and physical profiles. For social outcomes, increasing care provision is associated with fewer contacts, outings and holidays. For psychological and physical measures, carers providing a lot of care experience worse health. These results have implications for targeting appropriate interventions.
此前已有多项研究探讨了照料者的健康状况，但这些研究通常聚焦于老年受试者，且往往没有具有代表性的对照样本。
确定照料患有帕金森病的伴侣是否比照料未患帕金森病伴侣的人在社交、心理和身体健康方面恶化得更严重。
对154名帕金森病患者的照料配偶，以及124名从爱尔兰共和国一项关于早发性帕金森病的全国病例对照研究中随机选取的人群对照的非照料配偶进行了研究，该研究于1992年至1994年期间开展。结果从三个维度进行衡量：社交功能，通过社交接触、外出和度假的频率来评估；心理健康，通过一般健康问卷来测量；身体健康，通过照料者使用医疗服务、药物和慢性病发作情况来衡量。
照料配偶每周至少外出一次的可能性较小（优势比1.79，95%置信区间1.00 - 3.20），或者在过去一年中度假的可能性较小（优势比1.71，95%置信区间1.01 - 2.90）。随着照料时间的增加，与朋友和邻居的联系减少。对于提供大量照料的配偶，在调整其他变量后，精神疾病发病率几乎增加了五倍（优势比4.86，95%置信区间1.5 - 15.9）。大多数医疗结果在照料者中更不理想，但只有使用镇静剂（优势比3.73，95%置信区间1.18 - 11.8）和慢性病发作情况（优势比2.96，95%置信区间1.27 - 6.94）具有统计学意义。
总体而言，照料配偶的社交、心理和身体状况略差。在社交方面，照料时间增加与社交接触、外出和度假减少有关。在心理和身体方面，提供大量照料的照料者健康状况更差。这些结果对于确定合适的干预措施具有启示意义。
