Shaw W S, Patterson T L, Semple S J, Ho S, Irwin M R, Hauger R L, Grant I
San Diego State University, CA, USA.
Ann Behav Med. 1997 Spring;19(2):101-9. doi: 10.1007/BF02883326.
The hazards for experiencing major health events were studied longitudinally among 150 spousal caregivers of Alzheimer's disease (AD) patients and 46 married control participants. Based on longitudinal assessments from one to six years, the hazards of reaching any of three health events (extended physical illness or disability > 1 month, unhealthy medical rating from a nurse interview, or hospitalization) were not significantly different in a group comparison of caregivers to controls (Cox proportional hazards assumption, p > .05). However, there was a trend [X2(1, N = 107) = 3.13, p = .08] for caregivers to have a greater hazard for serious illness. Among caregivers only, a greater hazard for reaching at least one of these health events was associated with providing more activities of daily living (ADL) assistance [X2(1, N = 125) = 3.83, p = .05] but not with problem behaviors of the AD patient (p > .05). These results suggest that providing extensive ADL assistance may have health implications for spousal AD caregivers, while caregiving, per se, does not. Furthermore, these physical health impacts of caregiving may be best characterized using multidimensional assessments. Contrary to our guiding hypothesis, caregivers encountering more problem behaviors of their AD spouse were less likely to be hospitalized, X2(1, N = 145) = 5.88, p = .02. This finding may reflect a reluctance by caregivers to schedule necessary medical care when their spouses are most problematic, and this may have further long-term health implications for caregivers.
在150名阿尔茨海默病（AD）患者的配偶照顾者和46名已婚对照参与者中，对经历重大健康事件的风险进行了纵向研究。基于1至6年的纵向评估，在照顾者与对照者的组间比较中，发生三种健康事件（身体疾病或残疾持续超过1个月、护士访谈中的不良医疗评分或住院）中任何一种的风险没有显著差异（Cox比例风险假设，p>.05）。然而，照顾者患重病的风险有上升趋势[X2(1, N = 107) = 3.13, p = .08]。仅在照顾者中，发生至少一种这些健康事件的风险更高与提供更多日常生活活动（ADL）帮助有关[X2(1, N = 125) = 3.83, p = .05]，但与AD患者的问题行为无关（p>.05）。这些结果表明，提供广泛的ADL帮助可能对AD患者的配偶照顾者的健康有影响，而照顾本身则不然。此外，照顾对身体健康的这些影响可能最好通过多维评估来表征。与我们的指导假设相反，遇到AD配偶更多问题行为的照顾者住院的可能性较小，X2(1, N = 145) = 5.88, p = .02。这一发现可能反映出照顾者在配偶问题最多时不愿安排必要的医疗护理，这可能对照顾者有进一步的长期健康影响。
