诱导期血液透析病人家庭照顾者负担现状及其影响因素分析

[目的]调查诱导期血液透析病人家庭照顾者负担现状及其影响因素。[方法]采用一般情况调查表、病人日常生活能力量表(ADL)、照顾者负担问卷(CBI)、领悟社会支持量表(PSSS)对513例诱导期血液透析病人及513名家庭照顾者进行调查。[结果]诱导期血液透析病人家庭照顾者负担总分为(42.71±12.29)分,93.9%的家庭照顾者存在不同程度的照顾负担。病人日常生活能力、照顾者领悟社会支持、照顾者对血液透析的了解程度、照顾者家庭人均月收入是家庭照顾者负担的影响因素。[结论]诱导期血液透析病人家庭照顾者普遍存在不同程度的照顾负担,医护人员在提高病人日常生活能力和家庭照顾者社会支持水平基础上,根据诱导期的特点加强对家庭照顾者血液透析相关知识及技能的宣教与指导,对减轻照顾者负担、减少病人诱导期血液透析并发症的发生、使病人平稳过渡到维持期、提高病人及其家庭照顾者的生活质量十分重要。     

痴呆症病人家庭照顾者社会支持及相关因素研究

[目的]探讨居家痴呆症病人家庭照顾者社会支持及其相关因素。[方法]采用多点横断面研究设计,应用一般资料问卷、社会支持评定量表和照顾者负担量表对152位痴呆症病人的家庭照顾者进行测评,分析照顾者社会支持情况,探讨其相关因素及其对照顾者负担的影响。[结果]本组研究对象社会支持得分为(32. 26±5. 51)分,显著低于我国常模(t=-5. 158,P=0. 000);单因素分析显示配偶照顾者、不在业的照顾者、教育程度较低的照顾者以及与病人同住的照顾者社会支持总分或分维度得分较低(P0. 05),且照顾者年龄及每周照顾时间与社会支持总分或分维度得分呈负相关(P0. 05);除生理性负担和情感性负担两个维度外,照顾者负担总分及其他维度得分与不同维度的社会支持得分呈负相关(P0. 05)。[结论]本组居家痴呆症病人家庭照顾者社会支持情况不容乐观,针对社会支持的弱势群体、构建符合照顾者需求与特点的支持性干预措施意义重大,以期改善照顾者身心状况与照顾质量,提高照顾者与痴呆症病人双方的生活质量。     

乳腺癌病人主要照顾者的共情能力对家庭亲密度与适应性及病人生命质量的影响

[目的]探讨女性乳腺癌病人家庭亲密度与适应性、主要照顾者共情能力与病人生命质量之间的关系,摸索提高乳腺癌病人生命质量更有效途径。[方法]采用方便抽样法对广州某三级甲等医院的98例女性乳腺癌病人及其相应的主要照顾者98名进行问卷调查。问卷包括自制一般资料问卷、家庭亲密度和适应性量表、人际反应指针量表、乳腺癌病人生命质量测定量表。[结果]乳腺癌病人家庭亲密度得分为68.50分±10.26分,适应性得分52.85分±8.41分,生命质量得分113.80分±12.01分,主要照顾者人际反应指针量表总分为62.41分±10.43分;主要照顾者的人际反应指针量表得分(或分维度)、病人家庭亲密度及适应性与生命质量之间两两相关,且均呈正相关;主要照顾者共情能力对病人生命质量的影响经由家庭亲密度与适应性起作用,支持家庭亲密度与适应性的中介效应模型。[结论]乳腺癌病人主要照顾者的共情能力与其家庭亲密度及适应性对病人生命质量有正面影响,护理工作者可以通过增强照顾者的共情能力,提高其家庭亲密度和适应性,来进一步改善病人的生命质量。     

脑卒中病人再次入院与其家庭照顾者负担关系研究

[目的]了解脑卒中病人再次入院与其家庭照顾者负担关系,更好地为脑卒中照顾者提供支持性指导.[方法]用自设问卷和相关量表调查病人及其主要照顾者各100例,将再入院率与照顾者负担进行分析.[结果]2年内病人再次入院率为48%.照顾者负担与病人再入院有相关关系(P<0.05);照顾者的社会负担与病人的残疾程度、自理能力、焦虑、抑郁有关;与照顾者的焦虑、抑郁、社会支持和家庭经济状况有关.[结论]提高病人的自理能力,提高照顾者家庭经济和社会支持水平,对病人及其照顾者进行社会、心理干预,可减轻照顾者负担,降低再入院率.     

持续不卧床腹膜透析病人主要照顾者社会支持对生活质量影响的研究

[目的]探讨持续不卧床腹膜透析病人主要照顾者生活质量和社会支持的关系及影响因素,为提高腹膜透析病人主要照顾者的生活质量提供理论依据。[方法]采用世界卫生组织生活质量测定量表简表、社会支持量表和一般资料调查表对2017年5月—2017年9月于上海中医药大学附属龙华医院肾内科的130例持续不卧床腹膜透析病人主要照顾者进行调查,最终获得有效问卷120份。[结果]腹膜透析病人主要照顾者的生活质量在心理、生理、社会和环境4个领域得分均低于国内常模(P0.01);腹膜透析病人主要照顾者的生活质量各个领域得分与社会支持呈正相关(P0.01);多元逐步回归分析显示社会支持得分、累计照顾时间、家庭收入等因素主要影响腹膜透析病人主要照顾者的生活质量。[结论]腹膜透析病人主要照顾者生活质量有待提高,社会支持的改善有助于提高照顾者的生活质量。     

乳腺癌病人家庭照顾者负担及其影响因素分析

[目的]探讨乳腺癌病人家庭照顾者的负担水平及其影响因素。[方法]采用一般资料调查表、癌症病人家庭照顾者负担量表(CBS-CP)、癌症行为量表简洁量表(CBI-B)、医院焦虑抑郁量表(HADS)、简版生活质量量表(SF-12)和益处发现量表对70例乳腺癌病人家庭照顾者进行调查,并探讨其影响因素。[结果]乳腺癌病人家庭照顾者负担为0分～71分(32.14分±20.10分)。其中,41.4%报告无负担,32.9%报告为轻度负担,10.0%报告为中度负担;无重度负担的报告者。多元回归分析表明,照顾者总负担可能的预测变量为照顾者焦虑/抑郁、照顾者自我效能。[结论]乳腺癌病人家庭照顾者负担处于轻度负担水平,其影响因素涉及照顾者焦虑、抑郁及其自我效能等多方面。提示在临床实践中应注重开发降低照顾者焦虑、抑郁,提升其自我效能方面的干预措施,以降低照顾者负担水平,最终达到提升照顾者乃至病人生活质量的目的。     

慢性心力衰竭病人主要照顾者生活质量及影响因素研究

[目的]探讨慢性心力衰竭病人主要照顾者的生活质量现状并分析其影响因素。[方法]采用一般资料调查表、健康调查简表(SF-36)、医院焦虑抑郁量表、中文版慢性心力衰竭病人照顾者客观负担量表对116例慢性心力衰竭病人的主要照顾者进行调查。采用相关及多元回归分析影响因素。[结果]除生命活力维度外,主要照顾者的生活质量各维度得分均明显低于国内常模。相关分析发现,主要照顾者的年龄、与病人关系、是否与病人同住、是否患有疾病、实用照顾负担与生活质量的多个维度均有相关性。进一步的多元逐步回归分析发现,主要照顾者本身是否患有疾病、年龄及抑郁是其生活质量的主要影响因素。[结论]慢性心力衰竭病人主要照顾者的生活质量低于一般人群。医护人员在关注心力衰竭病人康复的同时,不能忽视主要照顾者本身的健康状况及生活质量。     

青少年精神分裂症病人照顾者家庭疾病负担现状与社会支持相关性研究

[目的]探究青少年精神分裂症病人家庭疾病负担与社会支持的相关性,为推动社区精神卫生服务和青少年病人特殊教育提供临床理论参考。[方法]采用随机抽样法,选取2017年12月—2019年3月3所三级甲等医院精神科青少年精神分裂症病人家庭照顾者201人,采用照顾者和病人一般情况调查表、家庭疾病负担量表、社会支持评定量表进行调查。[结果]201例病人照顾者家庭疾病负担量表总分(24. 68±9. 08)分,社会支持评定量表总得分为(31. 92±7. 94)分;家庭疾病负担与社会支持呈负相关(P0. 01),青少年精神分裂症病人照顾者社会支持程度显著低于全国常模及青少年抑郁症病人照顾者(P0. 01);照顾者人均月收入、婚姻状况、社会支持总分以及病人能否坚持服药、病程和自理程度是照顾者家庭疾病负担的主要影响因素,共解释家庭疾病负担总分变异的53. 2%。[结论]青少年精神分裂症病人照顾者家庭疾病负担总体处于中等偏下水平;社会支持水平较低。     

乳腺癌病人家庭照顾者照护负担影响因素的系统评价

目的:系统评价乳腺癌病人家庭照顾者照护负担的影响因素。方法:系统检索中国知网(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library、CINAHL、APA PsycArticles和Academic Search Complete数据库,检索时间为自建库至2022年4月6日。采用定性分析的方法总结归纳研究结果。结果:纳入11篇研究,样本量共计1 564例。乳腺癌病人家庭照顾者照护负担的影响因素有6项,分别为癌症病理分级、病人的日常生活活动能力、照顾者发生的生活应激事件、照顾者的焦虑抑郁情绪状态、家庭经济月收入和社会支持。结论:影响照顾者照护负担的影响因素复杂多样,应将病人和照顾者视为相互关联的一个整体,充分评估病人、照顾者和家庭社会三方面的因素,以制定个性化的干预措施减轻照护负担,提高病人和照顾者的生活质量。     

维持血液透析病人主要照顾者照顾负担及负性情绪与社会支持的相关性研究

[目的]探讨维持血液透析病人主要照顾者照顾负担及负性情绪与社会支持现状,并分析三者之间的关系。[方法]采用自制一般资料问卷、照顾者负担量表、焦虑(SAS)与抑郁(SDS)及社会支持评定量表对120名维持血液透析病人主要照顾者进行问卷调查。[结果]主要照顾者照顾负担量表得分为45.85为±12.41分,为中重度负担水平;SAS与SDS评分明显高于国内常模(P0.05);社会支持总分为30.09分±4.93分,低于国内常模的34.56分±3.73分(P0.05);主要照顾者社会支持与照顾负担、焦虑及抑郁负性情绪呈负相关(P0.05)。[结论]维持血液透析病人主要照顾者存在较高水平的照顾负担及负性情绪,医护人员及社会各界需对维持血液透析病人主要照顾者充分重视,提高维持血液透析病人主要照顾者的社会支持度,以降低照顾负担及负性情绪水平,促进主要照顾者的身心健康。     

Caregiver's burden, depression and support as predictors of post-stroke depression: a cross-sectional survey

To examine the effects of caregiver's burden, depression, and support on post-stroke depression (PSD), cross-sectional data were obtained from an epidemiologic survey of 225 stroke survivors and their caregivers living in Seoul, Korea. Multivariate analyses showed that, taking the clinical status of patients into account, caregiver's burden, depression and support were related to higher PSD. Perceived burden exerts adverse effects on PSD through its influence on the depression in caregivers. Hence, the care of stroke survivors that incorporates the care of caregivers is likely to reduce the risk of post-stroke depression in patients.     

Factors predicting the health status of caregivers of stroke survivors: A cross‐sectional study

In this cross‐sectional study, we aimed to determine factors influencing the health status of caregivers of stroke survivors. A total of 126 caregivers of stroke survivors were recruited from three outpatient clinics in Thai Nguyen National General Hospital, Vietnam, from November 2016 to March 2017. Data were collected through six instruments: a demographic questionnaire, the Modified Barthel Index, the Zarit Burden Interview Scale, the Multidimensional Scale of Perceived Social Support, the Family Caregiver Conflict Scale, and the Short Form‐36 Health Survey. Stepwise multiple regression was employed to analyze the data. Caregiver burden, patient's functional status, caregiver's age, and social support together explained 80.3% of the variations in health status of caregivers of stroke survivors. Caregiver burden was the strongest predictor of health status of these caregivers. Based on the findings, nurses should take caregiver's age, functional status of stroke survivors, caregiver burden, and social support into consideration when preparing family caregivers to provide care for stroke survivors. To reduce perceived caregiver burden, family support interventions should be embraced to enhance health status of the caregivers of stroke survivors.     

脑卒中家庭照顾者焦虑状况的调查及相关因素分析

目的研究脑卒中家庭照顾者的焦虑现状,探讨影响焦虑的相关因素。方法采用一般情况调查表和焦虑自评量表（SAS）对98例脑卒中患者家庭照顾者进行问卷调查。结果结果脑卒中家庭照顾者的焦虑得分明显高于国内常模（P〈0.05）,患者的肢体功能障碍、认知障碍和照顾者的性别、文化程度、每日照顾时间、家庭收入与照顾者的焦虑显著相关。结论建立多种渠道的信息支持,给予照顾者更多的情感和精神支持,从而减少他们焦虑的发生率。     

脑卒中患者家庭照顾者的应对方式和抑郁状况的调查

目的探索脑卒中患者家庭照顾者应对方式和抑郁水平的相关因素和预测因子。方法采用立意取样方法，选择92名患者及他们的照顾者完成调查问卷。结果脑卒中照顾者主要采用计划、正性重构、接受和积极应对四种应对方式；44．6％的照顾者有不同程度的抑郁症状；住院时间、功能和认知状况、家庭收入与照顾者的抑郁显著相关；应对方式中拒绝、自责、计划和信教与照顾者的抑郁显著相关；拒绝、计划两种应对方式和患者的功能状况是抑郁的预测因子。结论照顾者常采用适应性应对方式，但是他们的抑郁水平却很高。因此，应加强对家庭照顾者的关注。     

Depression and caregiver burden experienced by caregivers of Jordanian patients with stroke

Many stroke survivors will be cared for at home, primarily by their relatives. Providing care to a family member with a chronic disabling disease can be both emotionally and physically distressing for the caregivers. The purpose of this study was to investigate the relationship between patients' characteristics, duration of caregiving, daily caregiving time, caregiver's characteristics, caregiver depression and burden in caregivers of patients with stroke. A cross-sectional design was used with a convenience sample of 116 subjects. The Center of Epidemiologic Studies of Depression and the Caregiver Strain Index were used to identify caregiver depression and burden, respectively. Logistic regression analysis identified the influence of independent variables on caregiver depression and caregiver burden. Caregivers had high scores for depression and burden indices. Caregivers' health, receiving professional home health care and caregivers' burden were related to caregiver depression. Functional disabilities of patients with stroke and depression of caregivers were related to caregiver burden. To decrease caregiver depression and burden, nurses must provide caregivers with instructions for home management of patients with stroke. Development of specialized stroke home health services in Jordan that targets patients with stroke and their caregivers are recommended.     

Caregiving problems and feelings experienced by family caregivers of stroke survivors the first month after discharge

The purpose of this study was to identify the major problems and associated feelings experienced by family caregivers of stroke survivors during the first month after returning home. Safety, difficulty in managing activities of daily living, and cognitive, behavioral and emotional changes of stroke survivors (for example, mood swings, lack of motivation, forgetfulness and memory loss, depression and calling the caregiver often) were the three most common problems experienced by caregivers during the first month. Other problems were loss of caregiver independence, confinement, tiredness and inadequate time to do caregiving tasks as well as managing stroke survivor physical symptoms, for example, pain, not eating and skin problems. The first month of caregiving is very dynamic and distressful for caregivers of stroke survivors and telephone contacts appear to be beneficial in assisting caregivers to cope with the caregiving process.     

住院脑卒中患者主要照顾者负担及影响因素的研究

目的调查住院脑卒中患者主要照顾者的负担情况,并分析其影响因素。方法 2009年9-11月对75例住院的脑卒中患者及主要照顾者进行调查,包括主要照顾者的一般情况、照顾负担、社会支持和自我效能,被照顾者的一般情况、日常生活活动能力（actives of daily life,ADL）和认知能力。结果脑卒中患者主要照顾者负担总分为（32.45±16.11）分,为轻度负担水平;多因素分析显示,对社会支持的利用度、照顾者的教育水平、患者的ADL、与患者的关系及照顾者的自我效能是照顾者负担的影响因素。结论护理人员应了解脑卒中患者主要照顾者的负担水平及其影响因素,并提供有针对性的护理措施以减轻其负担。     

Caregiver care

In 2009, nearly 66 million Americans (three in 10 U.S. households) reported at least one person providing unpaid care as a family caregiver. More adults with chronic conditions and disabilities are living at home than ever before, and family caregivers have an even higher level of responsibility. Caring for loved ones is associated with several benefits, including personal fulfillment. However, caregiving is also associated with physical, psychological, and financial burdens. Primary care physicians can aid in the identification, support, and treatment of caregivers by offering caregiver assessments-interviews directed at identifying high levels of burden-as soon as caregivers are identified. Repeat assessments may be considered when there is a change in the status of caregiver or care recipient. Caregivers should be directed to appropriate resources for support, including national caregiving organizations, local area agencies on aging, Web sites, and respite care. Psychoeducational, skills-training, and therapeutic counseling interventions for caregivers of patients with chronic conditions such as dementia, cancer, stroke, and heart failure have shown small to moderate success in decreasing caregiver burden and increasing caregiver quality of life. Further research is needed to further identify strategies to offset caregiver stress, depression, and poor health outcomes. Additional support and anticipatory guidance for the care recipient and caregiver are particularly helpful during care transitions and at the care recipient's end of life.     

Stroke: coping strategies and depression among Chinese caregivers of survivors during hospitalisation

Aims and objectives. The main aim of this study was to identify the coping strategies of stroke caregivers, to identify the factors associated with caregivers’ depression and to identify predictors of caregivers’ depression. Background. Stroke has a high incidence in China. Most stroke survivors are accompanied by family caregivers during hospitalisation. However, little is known about these informal caregivers’ coping strategies to the consequences brought on by stroke and their depressive symptoms. Method. A correlation and cross‐sectional design was used and a purposive sample of 92 stroke survivors and their caregivers completed the questionnaires, which were used to describe the demographic of both the caregiver and stroke survivor, coping strategies (the Brief COPE Inventory) and depression of caregivers (the Center for Epidemiologic Studies Depression Scale). Spearman's correlation and multiple stepwise regression analysis were used in data analyses. Results. Several coping strategies (planning, positive reframing, acceptance, active coping, use of instrumental support and humour) were most commonly used by stroke caregivers. The length of hospital stay, stroke survivor's cognitive status and functional status, family income and coping strategies such as (i) denial, (ii) self‐blame, (iii) planning and (iv) religion had significant correlations with caregiver's depression. The best predictors of caregiver's depression were denial, planning and stroke survivor's functional status. Conclusions. This study contributes to our knowledge about the coping strategies and depression level of stroke caregivers on the Chinese mainland. The depression rate is very high during hospitalisation, although these caregivers often had positive coping responses to the stroke event. Many factors were associated with caregivers’ depression. Relevance to clinical practice. Nurses should not only pay attention to stroke survivors but also to their caregivers. To help them adjust well from the stroke consequences and avoid depression, nurses should implement effective interventions.