癌症患者家庭照顾者负担量表的研究进展

为探讨癌症患者家庭照顾者负担测评工具的研究现状,本文阐述并分析了2000年以来在癌症患者家庭照顾者负担测量方面应用较为广泛的几种照顾者负担测量工具:照顾者负担量表(ZBI),照顾者压力指标量表(CSI),照顾者反应评估量表(CRA),照顾者负担问卷(CBI)。并在此基础上提出应采用质性研究与量性研究相结合的方法,发展适合我国文化的癌症患者照顾者负担量表。     

老年癌症晚期患者家庭照顾者负担的现状及影响因素分析

目的探讨老年癌症晚期患者家庭照顾者负担现状,分析其相关影响因素。方法采用目的抽样法、问卷调查174名老年癌症晚期患者家庭照顾者,问卷包括自制一般资料问卷,Zarit照顾者负担量表。结果调查对象照顾者负担总分为(29.18±12.83)分,其中无照顾者负担者54名(31.03%),轻度负担86名(49.43%),中度负担29名(16.67%),重度负担5名(2.87%)。照顾者性别、是否患有慢性病及家庭支付医疗费用情况是相关影响因素。结论老年癌症晚期患者家庭照顾者普遍存在照顾负担,以轻度为主,应重视对照顾者身体状况、经济负担等方面的评估,采取针对性护理措施,帮助老年癌症晚期患者家庭照顾者有效实施照顾的同时减轻其身心负担,提高其生活质量。     

老年人家庭照顾者负担的相关研究进展

家庭照顾者在老年人居家养老中扮演着十分重要的角色.有研究报告老年人家庭照顾者的负担日益增加,其情绪、躯体健康、家庭生活及经济状况也受到了严重影响.缓解家庭照顾者的负担成了保障老年人生存质量的前提.本文旨在对老年人群家庭照顾者负担的概念、影响因素、评估工具及国内外干预现状进行综述.     

癌症患者家庭照顾者复发恐惧的研究进展

癌症复发恐惧在癌症患者的家庭照顾者中普遍存在,恐惧严重者会影响照顾者的生活质量,但照顾者对癌症复发的恐惧容易被医护人员忽视.该文从癌症患者家庭照顾者复发恐惧的相关概念、现状及影响、测评工具、影响因素、干预措施5个方面进行综述,旨在提高医护人员对癌症患者家庭照顾者复发恐惧的关注,为进一步开展相关研究提供参考.     

癌症患者家庭照顾者灵性需求的研究进展

综述了癌症患者家庭照顾者灵性及灵性需求的概念、灵性需求的种类、评估工具、优先排序以及影响因素, 旨在为安宁疗护团队识别癌症患者家庭照顾者灵性需求, 开展灵性关爱提供参考。     

怀旧疗法对老年癌症患者家庭照顾者照顾负担及积极体验的影响

目的探讨怀旧疗法对老年癌症患者家庭照顾者照顾负担及积极体验的影响。方法将81例老年癌症患者家庭照顾者随机分为对照组(n=42)和干预组(n=39),对照组接受常规健康教育,干预组在此基础上接受5周的怀旧疗法,干预前后分别采用照顾者负担量表(CBI)和照顾者积极感受量表(PAC)进行评定。结果干预后,干预组照顾者CBI总分及各维度得分明显低于对照组,差异有统计学意义(P0.05);干预组PAC总分及各维度得分高于对照组,差异有统计学意义(P0.05)。结论对老年癌症患者家庭照顾者采用怀旧疗法进行干预可降低照顾负担,提高照顾者的积极体验,同时,可提高癌症患者及其照顾者的生活质量,值得临床推广应用。     

血液透析患者家庭照顾者负担的调查

目的调查血液透析患者家庭照顾者负担，为维持照顾者健康及改善家庭护理质量提供依据。方法自行设计的问卷调查97例血液透析患者及家庭照顾者的一般资料，采用Zarit护理负担量表调查血液透析患者家庭照顾者负担、巴氏ADL量表评估血液透析患者的日常活动能力，应用Pearson相关分析法探讨上述变量之间的关系。结果照顾者负担与血液透析患者ADL、照顾者年龄、职业状况、婚姻状况、照顾年限、每天照顾时间显著相关（P〈0．05）。结论提高血液透析患者的日常活动能力并适当利用收费性家庭服务可减轻患者家庭照顾者的负担。     

274名晚期癌症患者家庭照顾者生活质量及其影响因素分析

目的了解晚期癌症患者家庭照顾者的生活质量及其影响因素。方法采用自行设计的一般资料调查表及世界卫生组织生活质量简表中文版,对274名住院晚期癌症患者家庭照顾者进行问卷调查。结果晚期癌症患者家庭照顾者生活质量4个维度中的生理、心理领域得分低于我国常模(P0.01)。多元逐步回归分析结果显示:家庭总月收入、照顾累计时间、照顾者性别及平时爱好是晚期癌症患者家庭照顾者生活质量的影响因素。结论晚期癌症患者家庭照顾者生活质量处于较低水平。医务人员应定期评估照顾者需求及健康状况,并结合照顾者实际情况给予其合理化照顾建议,同时鼓励照顾者培养兴趣爱好以提高其生活质量。     

家庭干预方案对肺癌化疗患者主要照顾者照顾负担及生活质量的影响

目的 探讨家庭干预方案对肺癌化疗患者照顾者照顾负担及生活质量的影响。方法 应用随机数字表法将入选的96对肺癌化疗患者及其主要照顾者随机分为实验组和对照组各48对;以主要照顾者作为研究对象,对照组实施常规护理,实验组在此基础上接受护理人员及肿瘤志愿者实施的家庭干预方案。12周后采用Zarit照顾者负担量表和癌症患者照料者生活质量调查表评价干预前后效果。结果 干预前两组主要照顾者的照顾负担评分及生活质量得分无统计学差异(P＞0.05),干预后实验组主要照顾者照顾负担评分明显低于对照组,生活质量评分明显高于对照组,差异均有统计学意义(P＜0.05)。结论 家庭干预方案能有效降低肺癌化疗患者主要照顾者的照顾负担,改善照顾者的生活质量。     

截瘫患者家庭照顾者负担及其影响因素分析

目的探讨截瘫患者主要照顾者的负担及其影响因素：方法采用照顾者负担问卷、特质应对问卷、家庭关怀指数、生活质量自评及Karnofsky活动指数对80例居家治疗截瘫患者的主要照顾者进行调查.结果截瘫患者家庭照顾者身体、心理、社会方面的负担较大,其中社交负担最重.与常模相比,照顾者更多采用消极应对方式,这种消极应对方式与照顾者负担呈正相关。照顾者负担与患者的活动指数、自理情况、主观生活质量、瘫痪时间、家庭关怀度指数,以及家庭经济负担相关：结论应重视截瘫患者家庭照顾者的负担,指导其采用积极的应对方式,加强家庭支持系统,积极鼓励患者自理,以减轻照顾者负担.     

老年临终患者家属照顾者照顾反应与社会支持的相关性研究

目的探讨老年临终患者家属照顾者照顾反应和社会支持关系。方法采用照顾者反应量表（CRA）和社会支持量表（MOS-SSS）对264例老年临终患者家属照顾者进行调查,并分析照顾反应各维度与其社会支持情况的关系。结果老年临终患者家属照顾者照顾反应自尊维度得分最高,其余消积结果中得分排名依次为时间受打扰、健康问题维度、经济问题维度和家庭支持维度。医疗结果研究的社会支持总分为（58.69±2.44）分,远低于常模标准;照顾反应中自尊维度与社会支持各维度无明显相关;其它各维度均与社会支持总分呈负相关（P〈0.05）。结论在为临终患者及家属照顾者提供临终关怀服务时,应重视社会支持状况与照顾者照顾反应之间的关系,提供针对该群体适合的护理措施,提高老年临终患者家属照顾者的社会支持水平,减轻照顾负荷,从而保障临终患者和照顾者双方的生活质量。     

Putting Evidence into Practice: nursing assessment and interventions to reduce family caregiver strain and burden

Family caregiving often is associated with multiple rewards, yet the diversity and intensity of caregiving roles also can result in caregiver strain and burden. Using interventions to reduce the strain and burden on caregivers of patients with cancer is an important role nurses play. This article is a critical review and synthesis of the evidence regarding assessment tools and interventions aimed at reducing caregiver strain and burden in the oncology population. Although the striking finding is the limited number of interventions targeted toward oncology caregivers, suggestions from the literature are offered to support and promote healthy outcomes for family caregivers.     

Effect of integrated caregiver support on caregiver burden for people taking care of people with cancer at the end of life: A cohort and quasi-experimental clinical trial

BackgroundPrevious studies have shown small-to-medium effects of support on reducing the caregiver burden for advanced cancer patients. A dearth of studies utilized longitudinal design to examine and evaluate the effect of support for the caregiving burden till the patient's death.ObjectivesTo test the ability of an integrative intervention program for caregivers of advanced cancer patients to lower caregiving burden as death approaches.DesignA two-group comparative design with repeated measures.SettingTwo cancer wards of a single university hospital.ParticipantsAdvanced cancer patients (N = 81) and their caregivers were allocated into two groups: an experimental group (N = 40) receiving coping strategies, assistance, recourses, and education intervention and a control group (N = 41) receiving standard care.MethodsCaregivers received training in the caregiver support intervention at least 3 times every 2 weeks to help them reduce their caregiving burden. Subjective (Caregiver Reaction Assessment) and objective (Heart Rate Variability) measures of caregiver burden were evaluated for caregivers of patients approaching death. Only data within 3 months before the patients’ death were analyzed.ResultsCaregiver self-efficacy significantly increased and the subjective caregiving burden significantly decreased in the experimental group as patients’ death approached. Heart Rate Variability also indicated a calming effect of the intervention, helping caregivers face patients’ death.ConclusionsThe caregiver support intervention can increase caregiver self-efficacy and reduce the subjective caregiving burden. Heart Rate Variability parameters have the potential to be useful for monitoring caregiver burden in facing patients’ death.     

Family caregivers of patients with frontotemporal dementia: An integrative review

ObjectivesThe purpose of this integrative review is to: (1) identify the characteristics of family caregivers of patients with frontotemporal dementia, (2) explore the impact of providing care on family caregivers’ health and well-being, and (3) identify coping strategies used by family caregivers.BackgroundFrontotemporal dementia is thought to be the second most common form of dementia after Alzheimer's disease. Family caregivers of patients with frontotemporal dementia face unique challenges due to its early onset, behavioral symptoms, and slow progression of decline. However, there is a dearth of research evaluating the health and wellbeing of family caregivers of patients with frontotemporal dementia.Design and data sourcesAn integrative review was conducted using the Whittemore and Knafl methodology. An electronic search of the literature was conducted using four electronic databases: PubMed, Embase, CINAHL, and Web of Science. The Crowe Critical Appraisal tool was used to evaluate the quality of the selected articles.ResultsFindings of 11 articles informed this integrative review. Family caregivers of patients with frontotemporal dementia identify behavioral disturbances as most troubling. Spouses and female caregivers experience greater caregiver burden, distress, increased rates of depression, as well as decreased sleep related to behavior disturbances. Though less explored, providing care to those with behavioral disturbances may also impact caregiver physical health. Additionally, female caregivers are most likely to employ coping strategies, most commonly, adaptation and reframing. Effective interventions to reduce family caregiver burden are poorly understood but family caregivers suggest education and internet-based support groups are most helpful.ConclusionsFamily caregivers of patients with frontotemporal dementia experience significant distress, which impacts their health and wellbeing. It is important for healthcare providers who care for patients with frontotemporal dementia to recognize the unique needs of family caregivers. Future research should focus on examining interventions and strategies to reduce caregiver burden.     

癌症患者家庭照顾者准备度现状及影响因素分析

目的：调查癌症患者家庭照顾者准备度现状并分析其影响因素,为今后开展癌症患者照护者的护理干预提供依据。方法：采用照顾者准备度量表对天津市某三级甲等肿瘤专科医院门诊266例癌症患者照顾者进行调查。结果：癌症患者照顾者准备度得分为（23.07±6.03）分,不同照顾者的年龄、职业、是否具有照顾经验、患者癌症种类、是否转移的照顾者准备度得分比较差异具有统计学意义（P＜0.05）,其中,中青年、有照顾经验、肿瘤未发生转移的患者照顾者准备度更高。结论：癌症患者照顾者准备度水平有待提高,医护人员应有针对性的为癌症患者的照顾者提供健康教育和咨询工作,以提高其照顾者准备度,改善癌症患者的生活质量。     

胃癌术后患者家庭照顾者负担及其影响因素分析

目的探讨胃癌术后患者家庭照顾者所承受的负担及其影响因素。方法对102名胃癌术后患者家庭照顾者进行问卷调查。结果胃癌术后患者家庭照顾者心理、社会方面的负荷较大。多元线性回归分析显示,照顾者负荷状况与患者病程分期、照顾者与患者的社会关系有关。结论应重视胃癌术后患者家庭照顾者的负担,采取有效的信息支持,进行居家照顾专题培训,以减轻照顾者负担。     

肺癌晚期患者照顾者负担状况及其影响因素分析

目的探讨肺癌晚期患者家庭照顾者负担状况及其影响因素。方法采用一般资料问卷和Zarit照顾者负担量表,对2009年12月至2010年10月住院治疗的肺癌晚期患者家庭照顾者227例进行调查。结果肺癌晚期患者家庭照顾者负担总分为(29.79±13.89)分,184例(76.7%)照顾者存在照顾负担,其中轻度负担者占53.7%。女性照顾者负担高于男性,家庭经济状况好者负担低于经济状况不好者,身体健康状况好者负担低于身体健康状况不好者,文化水平高的照顾者负担高于文化水平低者。结论肺癌晚期患者家庭照顾者普遍存在照顾负担,负担程度以轻度为主;照顾者性别、家庭经济状况、身体状况、文化水平等因素影响照顾者负担水平。     

不同阶段永久性造口患者的照顾者护理负担的影响因素调查分析

目的调查不同阶段永久性造口患者照顾者护理负担的影响因素。方法选择2015年7月-2016年7月在某三甲医院普外科及泌尿外科住院行永久性肠造口患者的63名主要照顾者为研究对象,采用一般资料调查表和Zarit护理负担量表,在出院1个月及出院3个月时进行问卷调查。结果出院1个月时的影响因素为造口并发症、照顾者文化程度、照顾者年龄、医疗付费方式、人均收入及照顾者性别6个因素;出院3个月时的影响因素为造口并发症、患者年龄、照顾者工作情况、照顾者年龄4个因素。结论照顾者在患者出院后不同阶段护理负担的影响因素是不同的,护理人员应针对照顾者的具体情况和时间阶段制定个性化延续护理方案,从而减少居家护理阶段照顾者的护理负担。