上海市城区失能老人主要照顾者照顾负担现状及其影响因素的研究

目的 调查上海市城区失能老人主要照顾者照顾负担现状,并分析其影响因素,为后期提供针对性干预方案提供依据。 方法 于2016年7月-12月采用便利抽样法对上海市浦东新区金杨社区440名失能老人的主要照顾者应用Barthel指数评定量表、照顾负担量表(zarit burden interview,ZBI)、社会支持量表、一般自我效能感量表(GSES)、医学应对方式问卷(MCMQ)和自制一般人口社会学情况调查表进行调查。 结果 失能老人主要照顾者照顾负担总分为47.93±13.03,呈中等程度负担水平;单因素分析显示照顾者负担在患慢性病数量、失能时间(个月)、Barthel指数、照顾者年龄、照顾者文化程度、照顾者是否在婚、与被照顾者之间的关系、每日照顾小时数、照顾者自评健康状况等级、家庭月收入等变量上分布差异有统计学意义;多因素回归分析显示,应对方式、社会支持、自我效能、Barthel指数、与被照顾者之间的关系、照顾者自身文化水平、失能老人患慢性疾病情况、每天照顾小时数是照顾负担的影响因素,多元相关系数R=0.812,决定系数R2=0.659。 结论 上海城区失能老人主要照顾者照顾负担处于中等水平,照顾负担的影响因素来自失能老人以及照顾者多方面。社区护士应同时评估失能老人和主要照顾者的情况,根据影响因素采取针对性的措施以减轻照顾者的负担。 

The current status and influencing factors of care burden among the family caregivers of the disabled elderly in Shanghai

Objective To investigate the care burden level and influencing factors among the family caregivers of the disabled elderly in communities in Shanghai and to provide insights for further intervention approaches. Methods A crosssectional survey based on convenience sampling was conducted among 440 family caregivers in Pudong district in Shanghai between July, 2016 and December, 2016. All subjects were investigated using the Zarit Burden Interview (ZBI), Social Support Ratings Scale (SSRS), Geneml Self-Efficacy Scale (GSES), Medical Coping Modes Questionnaire (MCMQ) and the general social and demographical material lists. Results The total score of care burden among family caregivers was a moderate burden level, scoring 47.93 ±13.03; Univariate analysis showed that the burden of caregivers was statistically significant in chronic disease and disability time (month), Barthel index, caregiver age, caregiver education level, marital status, the relationship between the caregiver and the disabled elderly, the daily care of time, caregiver's health, family income and other variables on the distribution difference. Multiple regression analysis displayed that the main factors affecting caregiver burden were coping modes score, social support level, self-efficacy level of the caregivers, Barthel index score, the relationship with the disabled elderly, the family caregivers education status, the number of chronic diseases of the disabled elderly and the daily caring time. The multiple correlation coefficient R=0.812, and the determination coefficient R2=0.659. Conclusion The care burden of family caregivers was in a moderate level and was influenced by diverse care receiver's and caregiver's characteristics. The community nurse should comprehensively assess the disabled elderly and their family caregivers, according to the influencing factors providing targeted measures to reduce the burden of caregivers.