先天性心脏病学龄前患儿主要照顾者负担及其影响因素分析

目的了解先天性心脏病学龄前患儿主要照顾者负担情况,探讨其影响因素。方法采用一般情况问卷、Zarit照顾者负担量表(Zarit caregiver burden interview,ZBI)对82名先天性心脏病学龄前患儿主要照顾者进行调查,采用多元线性逐步回归分析对照顾者负担的影响因素进行分析。结果 82名主要照顾者ZBI得分41~78分,平均(56.93±8.13)分,患儿年龄及主要照顾者文化程度、每天照顾患儿时间均是影响患儿主要照顾者负担的主要因素(P0.05)。结论先天性心脏病患儿主要照顾者的照顾负担较重,护理人员应从生理、心理方面给予患儿照顾者充分的关心和爱护,从而降低其照顾负担。     

Concept analysis: abuse of ageing caregivers by elderly care recipients

PURPOSE: The purpose of this article is to clarify the concept of abuse within the context of ageing women who are at risk for or experiencing physical or emotional injury inflicted by elderly family members for whom they provide care. BACKGROUND: The study of abuse of ageing individuals in family caregiving situations has traditionally focused on abuse of the dependent care receiver. However, evidence supports the health risks related to abuse of ageing caregivers as well. Women, usually spouses, daughters, or daughters-in-law, most frequently assume the caregiver role. METHODS: A modification of the strategies for concept analysis proposed by Walker and Avant (1995) is used to clarify the concept of caregiver abuse. Searches of the professional literature reveal that caregiver abuse is rarely addressed; therefore, the broader concept of elder abuse is reviewed and then placed within the general context of family caregiving. Audiotapes of the first session of a community based intervention research study entitled Intervention for the Abuse of Ageing Caregivers (Phillips et al., NIH Grant No. R01 DA-AG11155-01, 1996), in which ageing women caregivers described abusive caregiving situations, were analysed qualitatively using the principles of concept analysis. The audiotapes serve as a second source of data for the concept analysis process. FINDINGS: Antecedents, defining characteristics, and consequences of abuse of ageing caregivers were identified through the process of concept analysis. Model, contrary, and borderline cases are presented to illustrate the findings. CONCLUSIONS: Findings supported the need for awareness that ageing caregivers can be placed at risk by verbally and physically abusive behaviours of the elders for whom they provide care. Use of the term 'abuse' by health care professionals has potentially negative consequences for identification and intervention in cases of potential or actual caregiver abuse.     

Shedding light on elder abuse

Elder abuse as a social problem has become the focus of nursing research only in the past decade. As information about the incidence and prevalence of spousal and child abuse came to light, data emerged regarding dependent elderly being abused by adult caregivers, often their children. Documenting and defining elder abuse has been problematic because of a lack of consensual definition and the social stigma surrounding the problem. Standardized assessment methods are still lacking. Nursing research studies focusing on abuse have begun to clarify the variables of abuse and have helped to describe potentially abusive family caregivers. These studies have laid the groundwork for generating theory that will be useful to practitioners to identify and intervene in this family violence arena.     

老年痴呆照顾者虐待倾向风险评估模型的构建与评价

目的 分析长期护理机构老年痴呆照顾者虐待倾向相关因素,构建风险评估模型,为机构早期识别虐待高危人群及制订干预措施提供依据。方法 2018年7月—12月便利抽样8所长期护理机构中307名老年痴呆照顾者,采用一般资料调查表、照顾者虐待评估表、大五人格问卷、简易应对方式问卷、照顾者积极感受问卷、一般健康问卷12项进行调查。结果 自评照顾难度困难、照顾对象有精神行为症状是照顾者虐待倾向的危险因素(OR=8.668、4.412),照顾者宜人性、开放性是其虐待倾向的保护因素(OR=0.888、0.940)。得出风险评估模型为Y=15×X₁+10×X₂-8×X₃-4×X₄(X₁：自评照顾难度困难;X₂：照顾对象存在精神行为症状;X₃：宜人性;X₄：开放性);模型受试者操作特征曲线下面积为0.856,灵敏度为81.0%,特异度为68.2%,总符合率为74.6%,Hosmer-Lemeshow拟合优度检验显示P=0.515,模型拟合尚佳。结论 多种相关因素参与照顾者虐待倾向的发生过程,构建的风险评估模型预测效能尚佳,有一定的临床应用价值。     

老年慢性病病人照顾者的负担及其影响因素

[目的]了解老年慢性病病人照顾者的照顾负担现状,分析照顾者负担的影响因素。[方法]以老年慢性病病人及其照顾者的一般资料调查表、照顾者负担量表为研究工具,采用方便抽样法对212例老年慢性病病人照顾者进行问卷调查。[结果]老年慢性病病人主要照顾者的负担总分为（34.55±17.78）分;影响照顾者负担的因素有照顾者与病人的关系、病人年龄、病人病程、家庭经济状况。[结论]老年慢性病病人照顾者存在不同程度的照顾负担,社会应重视老年慢性病病人照顾者的负担,并采取积极有效的应对措施。     

恶性血液病患者化疗期间自我感受负担的调查研究

目的：调查恶性血液病患者化疗期间的自我感受负担状况,分析其影响因素。方法：采用白设的一般资料问卷、自我感受负担量表（SPBS）和患者体能状况评估表（ECOG）对200例恶性血液病患者进行问卷调查。结果：患者自我感受负担得分为（30．12±7．99）分,单因素分析结果显示,不同年龄、受教育程度、家庭人均月收入、医疗费用类别、照护者与患者的关系、照护者有无健康问题以及患者的体能状况评分,患者自我感受负担组间有统计学差异;多元逐步回归分析结果显示,患者受教育程度、家庭人均月收入、患者的体能状况评分以及医疗费用类别是影响患者自我感受负担的影响因素。结论：恶性血液病患者的自我感受负担处于中等水平,提示医护人员应关注患者的自我感受负担状况,及时提供心理疏导,降低患者的自我感受负担水平。     

164例老年痴呆患者主要照顾者哀伤现状及影响因素分析

目的 调查老年痴呆患者主要照顾者哀伤状况,并分析其影响因素。方法 采用便利抽样方法,选取2018年10月—2019年9月在鼓楼医院老年科病房诊疗的老年痴呆患者主要照顾者作为调查对象。采用照顾者哀伤量表简化版、一般自我效能量表、社会支持评定量表对其进行调查,采用多元线性回归分析老年痴呆患者主要照顾者哀伤影响因素。结果 164例老年痴呆患者主要照顾者哀伤总分为（63.74±10.75）分,多元线性回归分析结果显示,照顾者性别、年龄、文化程度、自我效能、社会支持以及患者疾病严重程度、病程进入回归方程（P<0.05）,共解释哀伤总变异的62.3%。结论 老年痴呆患者主要照顾者哀伤处于较高水平,照顾者性别、年龄、文化程度、自我效能、社会支持以及患者疾病严重程度、病程是照顾者哀伤程度的主要影响因素,护理人员采取针对性措施提高老年痴呆患者照顾者自我效能感和社会支持利用度,从而减轻其哀伤情绪。     

精神分裂症患者家庭主要照顾者心理脱离在照顾者负担和连带病耻感间的中介作用

目的：探讨精神分裂症患者家庭主要照顾者心理脱离在照顾负担与连带病耻感间的中介作用,为缓解其连带病耻感制定相应干预措施提供依据。方法：采用便利抽样法选取132例精神分裂症患者家庭照顾者为研究对象。采用一般资料调查问卷、心理脱离量表（PD）、照顾者负担量表(ZBI)、贬低-歧视感知量表（PDD）进行调查,运用多元回归中介效应分析及Bootstrap法进行验证。结果：精神分裂症患者主要照顾者的照顾负担与心理脱离呈负相关（r=-0.540,P<0.05））;照顾负担与连带病耻感呈正相关（r=0.629,P<0.05）;心理脱离与连带病耻感呈负相关（r=-0.688,P<0.05）;中介效应分析显示,心理脱离在照顾负担与连带病耻感之间起完全中介作用,效应值为78.42%。结论：在精神分裂症患者家庭主要照顾者中,心理脱离是照顾负担与连带病耻感的中介变量。医护人员应多关注精神分裂症患者主要照顾者的心理情况,采取积极措施提高其心理脱离水平,使其从繁重的照顾工作中脱离出来,进而促进其身心健康。     

220名维持性血液透析患者照顾者心理弹性现状及影响因素分析

目的 调查220名维持性血液透析患者照顾者的心理弹性现状,并分析其影响因素。方法 采用便利抽样法,于2022年1—3月在广州市某三级甲等医院选取220名维持性血液透析患者照顾者作为研究对象。采用一般资料调查表、心理弹性量表、匹兹堡睡眠质量量表、Zarit照顾者负担量表进行调查。采用多重线性回归分析探讨维持性血液透析患者照顾者心理弹性的影响因素。结果 220名维持性血液透析患者照顾者的心理弹性总分为（64.91±8.40）分;多重线性回归分析结果显示,睡眠障碍、照顾负担、性别、家庭人均月收入和受教育程度进入回归方程（P<0.05）,共解释总变异的27.9%。结论 220名维持性血液透析患者照顾者心理弹性处于中度水平,睡眠质量、照顾负担是维持性血液透析患者照顾者心理弹性的主要影响因素,临床血透护士应针对性地开展照顾者心理弹性的干预,开展人文关怀,进而提高其心理弹性水平。     

Factors present when battered women kill

Twelve women, imprisoned for killing their abusive male partners, were interviewed to determine factors present in battering relationships that end in homicide. Threats to kill made by the abuser, daily alcohol use by the man, and the presence of a firearm in the home existed in the majority of these relationships. Psychological abuse (e.g., enforced isolation, humiliation, and degradation) was perceived as more devastating than physical abuse. Although an escalation in the severity and frequency of violence, the occurrence of sexual abuse, and women's suicidal threats were also present, subjects indicated that these factors were less important reasons for taking lethal action. Knowledge of these factors may guide nurses as they assess and intervene in dangerous, potentially lethal, abusive situations.     

Suicide probability in psychiatric patients' primary caregivers: The role of care burden,alexithymia and some risk factors

BackgroundAlthough suicidal ideation seems to be related with both burden of care and alexithymia, there is no study investigating the correlation between these factors and suicide probability in informal caregivers of psychiatric patients in the literature.AimIn this study, it was aimed to determine the suicide probability in psychiatric patients' primary caregivers, and to evaluate the effects of care burden, alexithymia and some risk factors on suicide probability.MethodsThis study was conducted with 262 caregivers between February 2019 and December 2019. Data were collected with the Personal Information Form, Suicide Probability Scale, Zarit Burden Interview, Toronto Alexithymia Scale.ResultsThe mean score the caregivers obtained from the Suicide Probability Scale was 79.75 ± 59.29, and 17.9% of them were at risk for suicide. Also, caregivers' suicide probability was related to variables such as caregivers' sex, economic status, presence of any disease, duration of care, and patients' education level, psychiatric diagnosis, duration of illness, presence of physical illness, compliance with treatment. In addition, caregivers' burden and alexithymia levels were significantly associated with the participating caregivers' suicide probability.ConclusionsThis study demonstrates that approximately one out of every five caregivers was at risk for suicide. Therefore, hospital and community-based intervention strategies to support caregivers should be developed.     

Caregiver burden and health promotion

Few of the studies describing caregiver stress and burden have focused on the effects of caregiving on the ability of the caregiver to attend to his or her own health needs. Therefore, the major purpose of this study was to investigate whether the perception of burden is related to the health-promoting behaviors of caregivers of the elderly. One hundred twenty-one predominantly female caregivers, mean age 61.1 years, S.D. = 13.4, completed questionnaires measuring demographic and health-related factors, the Objective and Subjective Burden Scales, and the Health-Promoting Lifestyle Profile. Findings suggest that those perceiving lower subjective burden practice more health-promoting behaviors than those with higher subjective burden scores, confirming Pender's contention that situational factors, such as caregiver burden, may affect health promotion.     

中老年维持性血液透析患者主要照顾者负担水平及其影响因素分析

目的 调查中老年维持性血液透析患者主要照顾者负担现状,分析其相关的影响因素及探讨。方法 便利抽样某三级甲等医院,采用一般人口学问卷、应用Zait负担量表、社会支持量表、自我效能感量表对115例中老年血液透析患者主要照顾者进行调查分析,采用多元线性回归分析其影响的因素。结果 中老年血液透析患者主要照顾者负担总分为(41.50±13.85)分,回归分析显示：社会支持、自我效能、年龄、文化程度、婚姻状态、工作状态、家庭经济收入进入回归方程(P＜0.05)。结论 中老年维持性血液透析患者主要照顾者负担处于中等水平,受自社会支持、自我效能、婚姻状态、家庭经济收入影响。护理人员应及时评估主要照顾者负担的影响因素,扩大中老年维持性血液透析患者主要照顾者社会支持,提供相应的健康教育,增强信心,为今后干预提供依据,最终提高患者及照顾者的生活质量。     

Evaluation of a clinic-based parent education program to reduce the risk of infant and toddler maltreatment

Community-based parent education programs are a common component of service plans for abusive and potentially abusive parents. Despite their widespread use, few studies have evaluated the effect of such programs to change actual parenting behavior even though this is a key intervention goal. The purpose of this study was to evaluate whether a relatively brief and inexpensive clinic-based education program could benefit parents of infants and toddlers by alleviating parental stress and improving parent-child interaction. Participants were 199 parents of children 1 through 36 months of age who were at risk for parenting problems and child maltreatment due to serious life stress including poverty, low social support, personal histories of childhood maltreatment, and substance abuse. Program effects were evaluated in terms of improvement in self-reported parenting stress and observed parent-child interaction. Positive effects were documented for the group as a whole and within each of three subgroups: two community samples and a group of mothers and children in residential drug treatment. Additional analyses illustrated a dose-response relationship between program attendance and magnitude of gain in observed parenting skills.     

老年慢性心力衰竭患者出院过渡期照护者照护现状及影响因素分析

目的探讨老年慢性心力衰竭(CHF)患者出院过渡期照护者照护现状及影响因素分析。方法选择2018年3月至2019年11月该院收治的老年慢性心力衰竭患者及其照护者各120例为研究对象, 用自制一般资料调查问卷对研究对象进行资料收集和照护能力现状进行调查, 并采用单因素分析和多因素回归分析法对老年慢性心力衰竭患者照护者照护能力的相关影响因素进行调查研究。结果照护者为老年慢性心力衰竭患者配偶的75例(62.5%), 子女的25(20.83%), 年龄46~60岁的53例(44.17%), 在职的76例(63.33%), 每月照护所需费用<3 000元的61例(50.83%), 文化程度在初中以下的55例(45.83%), 照护者的照护能力平均分数为(27.45±9.45), 照护能力处于中下水平;健康状况、疾病了解程度、是否与患者同住、照护经历及应对能力均为影响老年CHF患者照护者照护能力的相关因素;健康状况、疾病了解程度、应对能力、照护经历均为老年CHF患者照护者照护能力的独立因素(P<0.05)。结论健康状况、疾病了解程度、应对能力、照护经历均为老年CHF患者照护者照护能力的独立因素, 临床应结合患者的病情及照护者照护能力的以上影响因素, 为其制定合理的治疗及护理对策, 进而提高照护者的照护质量, 使患者得到最佳的照护与护理, 具有积极的临床意义。     

231名城市老年人跌倒影响因素的调查

目的探索汕头市某机构老年人跌倒的影响因素,为进一步开展预防老年人跌倒干预措施提供依据。方法于2018年4月由经过培训的工作人员按统一标准对汕头市某机构231名老年人进行跌倒问卷调查和平衡能力测试。结果单因素分析结果表明,与老年人跌倒发生有关的因素有受教育程度、是否害怕跌倒、是否有心脏病、是否服用糖尿病药、是否小便失禁和平衡能力降低(P<0.05)。多因素分析结果表明老年人跌倒的保护因素为受教育程度在大专及以上(OR=0.25,95%CI:0.10-0.63);危险因素包括服用糖尿病药(OR=3.81,95%CI:1.01-14.33)、小便失禁(OR=6.48,95%CI:1.32-31.72)和平衡能力降低(OR=3.50,95%CI:1.71-7.15)。结论服用糖尿病药、小便失禁、平衡能力降低会增加老年人跌倒风险,而较高的受教育程度是保护因素,建议今后根据老年人跌倒影响因素开展有针对性的预防研究。     

老年鼻咽癌病人家庭照护者对缓和医疗需求及相关因素分析

[目的]了解老年鼻咽癌病人家庭照护者对缓和医疗需求的现状,分析相关因素。[方法]采用简单随机抽样法,于2018年2月—2019年8月选取广西医科大学附属第一医院老年鼻咽癌病人的家庭照护者为研究对象。采用自行设计的问卷,调查家庭照护者的一般资料及对缓和医疗的需求情况,分析影响家庭照护者对缓和医疗需求因素。[结果]老年鼻咽癌病人家庭照护者对缓和医疗需求总分为(89.11±14.78)分,其中以照护者精神心理需求的得分指标最高;拟合多元线性回归分析结果显示,年龄、有无照护经验及与病人关系是影响家庭照护者对缓和医疗需求的独立因素(P<0.05)。[结论]老年鼻咽癌病人家庭照护者对缓和医疗需求程度高,且需求愿望与照护者年龄、有无照护经验及与病人关系有关,应具有针对性进行专业知识宣教及心理健康教育,有助于改善家庭照护者的心理状态,优化病人的生活质量。     

视网膜母细胞瘤患儿主要照顾者照顾负担及影响因素分析

目的：探讨视网膜母细胞瘤（RB）患儿主要照顾者的照顾负担水平及其影响因素。方法：采用一般资料调查表、Zarit照顾者负担量表（ZBI）及社会支持评定量表（SSRS）对180例视网膜母细胞瘤患儿的主要照顾者进行调查。结果：视网膜母细胞瘤患儿主要照顾者的照顾负担总分为（44.37±14.27）分,社会支持总分为（36.62±7.69）分。回归分析结果显示,患儿年龄、疾病治疗时间、主要照顾者的照顾时长、工作状况、费用支付方式、社会支持是影响患儿主要照顾者照顾负担的主要因素,解释照顾负担变异的45.3%。结论：视网膜母细胞瘤患儿主要照顾者的照顾负担处于重度水平,建议护理人员采取积极的应对方式,帮助减轻照顾负担,从而提高照顾质量。