结核病患儿家庭照顾者的照顾负担与生活质量现状及相关性研究

目的 了解结核病患儿家庭照顾者所承受的照顾负担和生活质量现状,并探讨两者之间的相关性,为制定系统性家庭干预措施提供参考。 方法 研究采用Zarit照顾者负担量表和家庭照顾者生活质量量表,对2017年9月至2018年3月在上海市公共卫生临床中心结核科住院的结核病患儿的家庭照顾者76名进行调查。Zarit照顾者负担量表总分0~88分,分值越高表明该照顾者负担越重,0~19分为无或很少负担,20~39分轻度负担,40~59分中度负担,60分以上重度负担。家庭照顾者生活质量量表总分16~80分,分值越高,表明照顾者生活质量越高。采用t检验、单因素方差分析、秩和检验对组间资料进行比较,采用Pearson相关分析或Spearman相关分析进行相关性检验。 结果 结核病患儿家庭照顾者照顾负担总分为(41.39±14.86)分,其中个人负担(22.58±9.10)分,责任负担(10.79±4.88)分。家庭照顾者生活质量总分为(50.46±14.25)分,4个维度得分由低到高依次为精神维度(11.61±4.53)分、心理维度(12.70±4.40)分、社会维度(13.01±3.62)分、生理维度(13.14±3.72)分。Pearson相关分析显示,照顾者照顾负担总分与生活质量总分呈负相关(r=-0.726,P<0.001),存在显著线性相关。 结论 结核病患儿家庭照顾者存在不同程度的照顾负担,将影响家庭照顾者的生活质量。     

老年期痴呆照顾者照顾感受与疲劳的相关性

目的探讨老年期痴呆照顾者的照顾感受与疲劳的相关性。方法运用照顾者负担量表(CBI)、照顾者积极感受量表(PAC)和疲劳量表(FS-14)对重庆市190名老年期痴呆照顾者进行问卷调查。结果老年期痴呆照顾者的照顾负担、积极感受和疲劳得分分别为(51.18±8.90)分、(29.20±5.48)分、(7.95±2.72)分;照顾者疲劳与照顾负担呈显著的正相关(r=0.56,P<0.01)、与积极感受呈显著的负相关(r=-0.33,P<0.01)。结论老年期痴呆照顾者沉重的照顾负担会加重疲劳,而增加积极感受可减轻疲劳。积极采取有效、可行的护理措施减轻照顾者负担、增加积极感受可能会缓解照顾者的疲劳状况,进而提高对老年期痴呆患者的照顾质量。     

肝癌患者家属疾病不确定感与生活质量现状及相关性

目的探讨肝癌患者家属的疾病不确定感和生活质量现状及两者之间的相关性。方法采用一般资料问卷、中文版疾病不确定感家属量表(PPUS-FM)和癌症患者家属生活质量量表(CQOL-C)对2013年1月至2016年6月武汉市汉口医院收治的肝癌患者的家属进行问卷调查,采用SPSS19.0软件对数据进行统计分析。结果共发放调查问卷211份,回收有效问卷203份,有效问卷回收率96.21%。肝癌患者家属疾病不确定感总分50~137分,总体评分(93.37±15.56)分,平均(3.08±0.41)分,疾病不确定感低水平者占6.40%,中水平者74.88%,高水平者18.72%;肝癌患者家属生活质量总体评分(170.22±39.85)分,平均(38.71±5.53)分。经Pearson积矩相关分析,疾病不确定感总分与躯体状况、心理状况、社会功能状况及精神状况呈负相关关系(r=-0.389、-0.513、-0.506、-0.492,P<0.05),疾病不确定感中不确定性与心理状况、精神状况呈负相关关系(r=-0.435、-0.302,P<0.05),信息缺乏性与心理状况呈负相关关系(r=-0.192,P<0.05),不可预测性与心理状况、精神状况呈负相关关系(r=-0.437、-0.326,P<0.05)。结论肝癌患者家属存在不同程度的疾病不确定感,随着疾病不确定感的增强,生活质量越低。     

HIV/AIDS患者社会支持 心理弹性与生活质量间的关系

目的 探讨HIV/AIDS患者生活质量现状及其与社会支持、心理弹性的关系,分析心理弹性的中介作用。方法 于2019年1月至2021年12月,采用一般资料问卷、医疗社会支持量表（MOS-SSS-C）、心理弹性量表（CDRISC）、世界卫生组织艾滋病生活质量量表简表（WHOQOL-HIV-BREF）对220例HIV/AIDS患者进行问卷调查。采用SPSS 21.0进行统计分析,经描述统计、单样本t检验或单因素方差分析、Pearson相关分析,使用SPSS PROCESS进行中介效应检验。结果 220例HIV/AIDS患者中最终回收有效问卷200份。HIV/AIDS患者社会支持总分为（73.96±7.57）分,心理弹性总分为（66.44±10.17）分,生活质量总分为（73.75±2.86）分。HIV/AIDS患者的社会支持与心理弹性、生活质量呈正相关（r=0.313、0.212,P均<0.05）;心理弹性与生活质量呈正相关（r=0.243,P<0.05）。心理弹性在医疗社会支持与生活质量中起到部分中介作用,中介效应占总效应的比例为12.51%。结论 HIV/AIDS患者生活质量...     

心理弹性对胃癌根治术患者癌症复发恐惧的作用:领悟社会支持的调节效应

背景胃癌根治术后患者对癌症复发恐惧(fear of cancer recurrence, FCR)心理将严重影响生活质量.心理弹性能使患者保持良好的心理状态去面对逆境,可能会减轻FCR的影响作用.而良好的社会支持对个人的心理健康具有重要作用,积极的领悟社会支持可通过增强心理弹性的作用而减轻负面情绪.目的探讨心理弹性对胃癌根治术患者FCR的作用以及领悟社会支持在二者间的调节效应.方法选择2018-02/2019-08在我院住院的120例胃癌根治术患者为研究对象,采用汉化版癌症患者恐惧疾病进展简化量表,心理弹性量表以及领悟社会支持量表进行调查,然后统计分析.结果胃癌根治术患者FCR得分42.3分±7.6分.其中,在职患者FCR得分41.8分±7.2分,高于非在职患者FCR得分39.1分±6.9分(P0.05);医疗负担很重和有一定医疗负担患者FCR得分分别为42.9分±8.2分、42.1分±6.9分,均高于基本无负担患者FCR得分38.9分±7.1分(P0.05).而胃癌根治术患者一般资料中的其他方面FCR得分(P0.05).胃癌根治术患者的FCR分与领悟社会支持总分和心理弹性得分均呈负相关(r=-0.144,-0.271, P 0.05),领悟社会支持总分以及各分量表得分与心理弹性均呈正相关(r=0.365, 0.348, 0.323,0.373, P 0.05).采用分层多元线性回归分析,结果表明对FCR具有负向预测作用(β=-0.236, P0.01),且领悟社会支持在心理弹性和FCR两者间起到了调节作用(β=-0.182, P0.01).其中家庭支持(β=-0.164, P=0.003,△R~2=0.025),朋友支持(β=-0.175, P=0.001,△R~2=0.027),其他支持(β=-0.141, P=0.008,△R~2=0.025)均能在心理弹性和FCR间起到调节作用.结论心理弹性对胃癌根治术患者的FCR有直接影响作用;领悟社会支持水平的升高会增强心理弹性对FCR的影响,从而进一步降低FCR水平.     

帕金森病患者生活质量与其主要照顾者知信行的相关性

目的了解帕金森病(PD)患者生活质量(QOL)及其主要照顾者知信行(KAP)现状,并探讨二者相关性。方法采用自行设计的KAP问卷,世界卫生组织(WHO)生活质量量表对南昌市某三甲医院68例PD患者及其主要照顾者进行问卷调查。结果照顾者KAP总分为(62.77±10.85)分,PD患者生活质量总分为(46.29±5.21)分,KAP得分与PD患者生活质量得分密切相关(r=0.196,P0.01)。结论 PD患者生活质量及其主要照顾者的KAP水平均不高。     

化疗期老年癌症患者照顾者负担与生活质量的相关性

目的了解化疗期老年癌症患者照顾者负担水平和生活质量的现状,探讨两者相关性。方法对化疗期老年癌症患者的照顾者使用一般资料调查问卷,照顾负担量表(ZBI)和癌症患者照顾者生活质量评定量表(CQOL)进行调查。结果照顾者负担得分为(24.12±11.41)分,57%的照顾者负担处于中重度水平;照顾者生活质量得分(176.58±40.65)分;负担总分及各维度与生活质量总分及各维度呈显著负相关(均P<0.05),其中负担总分与生活质量的社会适应维度相关显著(P<0.01)。结论化疗期老年癌症患者照顾者负担与生活质量存在不同程度的负相关,医护工作者应给予照顾者一定的支持尤其鼓励其适当开展正常的人际交往或其他形式的社会活动,以减轻其照顾负担,改善生活质量。     

帕金森病患者主要照顾者负担与社会支持及其相关性

目的了解帕金森病(PD)患者主要照顾者负担与社会支持状况及两者的相关性。方法采用照顾者负担问卷(CBI)、社会支持评定量表(SSRS)对2014年6~12月南昌市某三甲医院60例PD患者的主要照顾者进行调查分析。结果 PD患者主要照顾者的负担处于中等水平(45.99±12.18)分,社会支持处于中等水平(30.08±4.32)分。主要照顾者负担与社会支持水平呈负相关(r=-0.302,P<0.05)。结论提高PD主要照顾者的社会支持度可有效降低照顾者负担水平,并最终提高对PD患者的照护质量。     

长期护理机构老年痴呆照顾者负担与患者精神行为症状的相关性

目的探讨机构照顾者负担与老年痴呆患者精神行为症状的相关性及可能的影响因素。方法采用护理院版神经精神问卷、照顾者负担量表、照顾者积极感受量表、状态焦虑量表、抑郁自评量表、智力障碍者照顾困难量表及自制信息采集表对长期护理机构112例老年痴呆患者及35名痴呆照顾者进行调查。结果机构老年痴呆患者的照顾者负担总均分(40.57±11.82)高于常模(t=9.20,P=0.00);其中,生理性负担(66.94%)和时间依赖性负担(62.00%)得分率最高。照顾者焦虑(39.57±8.25)、抑郁(11.68±5.49)自评结果与国内常模无统计学差异(P>0.05)。患者精神行为症状严重程度与照顾者照顾困难呈正相关(r=0.40,P=0.04),但二者与照顾者负担不相关(P>0.05)。机构照顾者对精神行为症状的应对知识和技能需求最高(89.3%),但因"难以应对患者的精神行为症状"而离职的意愿最低。结论长期护理机构应对老年痴呆患者的照顾者进行精神行为症状照护知识和技能培训,提高照护质量,并采取有效措施,减轻照顾者的生理性和时间依赖性负担。     

脑卒中患者生活质量与其主要照顾者知信行的相关性

目的了解脑卒中患者生活质量及其主要照顾者的知信行现状,探索二者的相关性。方法采用自行设计的知信行问卷,世界卫生组织(WHO)生活质量量表简表对福州市3所医院和4个社区的230名对脑卒中患者及其主要照顾者进行调查;采用统计描述和Spearman相关分析等对资料进行统计分析。结果照顾者的知信行总分为(109.14±15.16)分,脑卒中患者生活质量总分为(50.59±6.90)分,知信行得分与脑卒中患者生活质量得分密切相关(r=0.199,P<0.01)。结论脑卒中患者的生活质量及其主要照顾者的知信行水平均不高,二者呈正相关。     

Quantitative evaluation of the burden of those giving home care for senile dementia of Alzheimer type subjects using the burnout scale of pines]

We quantitatively measured the physical and psychological burden of caregivers of 25 patients with senile dementia of Alzheimer type (SDAT). The Barthel Index (BADL, full score: 20 points) and the caregiver burden in terms of physical symptoms correlated well (r = -0.964, p < 0.001), as did the degree of abnormal behavior and caregiver burden in terms of psychological symptoms (r = 0.946, p < 0.001). The correlation with the burnout scale (BOS) of Pines was best when both factors of psychological and physical symptoms were included. The correlation between BOS and the caregiver burden in terms of both physical and psychological symptoms was r = 0.874, p < 0.001, and the correlation between BOS and "the degree of abnormal behavior" +(20- "BADL") was r = 0.853, p < 0.001. The burden in terms of physical symptoms increased as the BADL score decreased, but the burden in terms of psychological symptoms increased initially and decreased in the last phase of the disease. We conclude that the BOS score of SDAT caregivers was stable in the initial phase, then increased rapidly, thereafter preserved high, and dropped rapidly as the BADL score decreased.     

A comparison of caregivers for elderly stroke and dementia victims.

OBJECTIVE: To compare elderly co-resident caregivers of stroke and dementia patients on measures of burden and psychological morbidity. DESIGN: Cohort study. SETTING: Caregivers interviewed at home. SUBJECTS: Convenience sample, 99 co-resident caregivers of dementia and stroke patients registered with a community rehabilitation and geriatric service and who were 60 years or over. MAIN OUTCOME MEASURES: Caregiver burden as measured by self-administered questionnaire and subsequent interview, using the Relatives Stress Scale (RSS) and psychological morbidity as measured on the General Health Questionnaire (GHQ). RESULTS: Forty-six percent of caregivers had significant psychological morbidity (GHQ greater than 4). Mean RSS score was 12.2 (SD 5.4). No significant differences were found between stroke and dementia caregivers on these measures. Caregiver burden was significantly correlated with psychological morbidity in both caregiver groups. Behavior and mood disturbance in the patient was significantly correlated with burden (dementia caregivers r = 0.66; stroke caregivers r = 0.49, P less than 0.0001) and psychological morbidity (dementia caregivers r = 0.44, P less than 0.01; stroke caregivers r = 0.30, P less than 0.05). Caregiver's dissatisfaction with participation in life activities was correlated with burden (dementia caregivers r = 0.58; stroke caregivers r = 0.63, P less than 0.0001) and psychological morbidity (dementia caregivers r = 0.67, stroke caregivers r = 0.56, P, 0.0001). CONCLUSION: Elderly co-resident caregivers for stroke and dementia patients experience similar degrees of burden and high levels of psychological morbidity. Psychiatric aspects of chronic disability, rather than physical aspects, were found to be more stressful to caregivers. All assessments of the disabled elderly should include measures of caregiver burden and psychological distress.     

Predictor of increase in caregiver burden for disabled elderly at home

In order to classify the caregivers at high risk of increase in their burden early, linear discriminant analysis was performed to obtain an effective discriminant model for differentiation of the presence or absence of increase in caregiver burden. The data obtained by self-administered questionnaire from 193 caregivers of frail elderly from January to February of 2005 were used. The discriminant analysis yielded a statistically significant function explaining 35.0% (Rc=0.59; d.f.=6; p=0.0001). The configuration indicated that the psychological predictors of change in caregiver burden with much perceived stress (1.47), high caregiver burden at baseline (1.28), emotional control (0.75), effort to achieve (-0.28), symptomatic depression (0.20) and "ikigai" (purpose in life) (0.18) made statistically significant contributions to the differentiation between no increase and increase in caregiver burden. The discriminant function showed a sensitivity of 86% and specificity of 81%, and successfully classified 83% of the caregivers. The function at baseline is a simple and useful method for screening of an increase in caregiver burden among caregivers for the frail elderly at home.     

The effect of rheumatoid arthritis on the quality of life of primary caregivers

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic and disabling disease frequently leading to physical and psychological dependence, with considerable economic consequences. Responsibility for care of the patient is taken on by a member of the family called the primary caregiver. Studies of caregivers of patients with RA are scarce. A better understanding of the caregiver's situation could provide interventions that reduce the burden and postpone institutionalization of people with arthritis disability. Our objective was to assess the effect of RA on the quality of life of primary caregivers. METHODS: Sixty-two patients from the rheumatic disease outpatient clinic and their respective caregivers were interviewed. Demographic and clinical data were recorded. Health and psychological status were measured using the Health Assessment Questionnaire (HAQ), Medical Outcomes Survey Short Form 36 (SF-36), Self-Reporting Questionnaire (SRQ-20), and a numerical pain rating scale. Burden of disease on the caregiver was assessed by the Caregiver Burden scale (CB scale). RESULTS: The majority of caregivers were women (82.3%), married (59.7%), mean (SD) age of 39.7 (15.7) years, with children/son (32.7%) or spouse (24.2%), with low education level and low income. Thirty-seven percent displayed psychoemotional disturbance measured by SRQ-20. Emotional aspect and mental health (by SF-36) were the most affected. The mean (SD) score of total burden experienced was 1.82 (0.59). The quality of relationship between caregivers and patients and SF-36 mental health of caregivers were important predictors of burden. CONCLUSION: Caregivers of patients with RA show high prevalence of psychological disturbance. The quality of the relationship between caregivers and patients and the mental health of the caregiver are important predictors of the burden of disease.     

Mediating effect of social support on the relationship between resilience and burden in caregivers of people with dementia

ObjectiveThis study examined different predictive factors of burden in a sample of family caregivers of patients with dementia (PWD). In particular, the influence of social support and resilience on burden was tested, considering potential mediation effects.MethodsA total of 283 primary and family caregivers in Spain were evaluated using a standardized protocol to assess sociodemographic characteristics, clinical state of PWD and specific variables of caregiving and care providers.ResultsThe role of caregiver of PWD was more common in women, reporting significantly higher levels of burden than men. Resilience and social support accounted for most of the variance in burden. Furthermore, social support partially mediated the relationship between resilience and burden in caregivers.ConclusionsCaregivers’ resilience and social support are protective factors against burden in caregivers of PWD. Both factors should be considered for tailored interventions aimed at reducing the health costs of burden in this population.     

Life worth living for caregiving and caregiver burden among Japanese caregivers of the disabled elderly in Japan

The aim of this study is to determine the relationship between life worth living and caregiver burden among caregivers in Japan. We used 111 caregivers of frail elders who completed a self-administered questionnaire including the 8 items developed by Arai et al. (J-ZBI) used as a scale to measure subjective burdens and psychological factors used as covariates other than life worth living. Total score (0-32) of the J-ZBI was dichotomized into "high burden" (> or =21 points) and "low burden" (<21 points). Multivariate logistic regression analysis revealed that only life worth living was significantly associated with caregiver burden. The direct effect of life worth living on caregiver burden (92.9%) was much greater than the indirect effect (7.1%). Our findings suggest that the increase of the sense of life worth living may play an important role in the prevention of the development of caregiver burden.     

Assessment of the burden of caregiving for patients with chronic obstructive pulmonary disease

OBJECTIVE: To determine the effect of chronic obstructive pulmonary disease (COPD) on the quality of life of caregivers. DESIGN AND METHODS: A cross-sectional study was carried out with forty-two COPD patients and their primary caregivers. Patients were assessed with the medical outcome survey short form (SF-36), the physical and mental component summary (PCS and MCS), Saint George's respiratory questionnaire (SGRQ), 6-min walking test, and spirometric and blood gas measurements. Caregivers were assessed using the medical outcome survey short form (SF-36), the physical and mental component summary (PCS and MCS), the 5-point Likert scale for measuring caregiver/patient relationships and the caregiver burden scale (CB scale). RESULTS: The majority of caregivers were female (85.3%), married (59%) and had low levels of income and schooling. The mean age was 51.6+/-16 years. Mean caregiver PCS and MCS scores were 45.9+/-10 and 46+/-12, while the mean total burden score was 1.79+/-0.6. The regression analysis showed caregiver/patient relationship quality, caregiver MCS scores and patient PCS scores to be important predictors of burden and explained 63% of the variance. CONCLUSIONS: COPD causes a significant impact on the quality of life of caregivers. The two most important predictors of COPD burden are the relationship between caregivers and patients and caregiver MCS scores.     

Caregiver burden and health-related quality of life among Japanese stroke caregivers

OBJECTIVE: the present study had two main purposes: 1. To examine the relationship between caregiver burden and health-related quality of life in family caregivers of older stroke patients in Japan; and 2. To examine which characteristics of the caregiving situation significantly relate to increased burden. METHODS: subjects (n=100) were recruited from seven randomly selected neurological hospitals with out-patient rehabilitation clinics in western Japan and interviewed using the Zarit Burden Interview, the Modified Barthel Index, the Geriatric Depression Scale and the SF-12 Health Survey for health-related quality of life. RESULTS: increased caregiver burden was significantly related to worsening health-related quality of life, particularly worsening mental health (Geriatric Depression Scale and SF-12 items), even after controlling for caregiver age, sex, chronic illness, average caregiving hours/day, and functional dependence of the care-recipient. DISCUSSION: findings indicate that increased burden significantly relates to decreased health-related quality of life among stroke caregivers. In addition, the prevalence of depressive symptoms among caregivers was twice that of community dwelling older people. Roughly 52% of caregivers had Geriatric Depression Scale scores that warranted further evaluation. Despite the prevalence of depressive symptoms only one caregiver had received any psychiatric care during their caregiving tenure.