首发脑卒中老年患者家庭照顾者准备度现状及影响因素分析

目的：探讨首发脑卒中老年患者家庭照顾者照顾准备度现状并分析其影响因素。方法：选取首发脑卒中老年患者及主要照顾者各160名为研究对象。应用照顾者准备度量表、照顾者首发脑卒中相关知识水平量表和医疗社会支持量表对照顾者进行调查。结果：首发脑卒中家庭照顾者的照顾准备度得分为（23.53±6.18）分;首发脑卒中患者照顾者准备度与照顾者脑卒中相关知识水平呈正相关（r=0.309,P<0.05）,与家庭社会医疗支持水平呈正相关（r=0.248,P<0.05）。多因素分析显示,照顾者有无照顾经验、照顾者的人数、患者的Rankin等级、照顾者脑卒中相关知识水平、医疗社会支持水平为首发老年脑卒中患者家庭照顾者准备度的影响因素（P<0.05）。结论：首发脑卒中老年患者家庭照顾者准备度有待提高。医护人员应及时给予健康宣教,并帮助患者和照顾者制定个性化的康复方案。     

恶性肿瘤患者家庭照顾者准备度现状及影响因素分析

目的：调查分析恶性肿瘤患者家庭照顾者准备度现状及其影响因素,以提高恶性肿瘤患者的照顾者的照顾质量。方法：选择2018年4月到7月住院治疗的恶性肿瘤患者家庭照顾者160例为研究对象,采用一般资料调查表、照顾者准备度量表对其进行现况调查。结果：恶性肿瘤患者照顾者准备度总分为（14.03±2.58）分;多元线性回归分析结果显示,照顾者年龄、与患者关系、个人月收入、患者文化程度和是否知晓病情是家庭照顾者照顾准备度的影响因素（P<0.05）。结论：临床工作中应根据患者及照顾者的具体情况进行个性化干预和指导,以提高恶性肿瘤患者的照顾质量,促进健康。     

癌症患者中青年照顾者逆境商现状及其影响因素分析

目的：调查癌症患者中青年照顾者逆境商现状并分析影响逆境商的因素,为制定针对中青年照顾者的干预策略提供依据。方法：2020年1月至6月采用照顾者一般资料调查表、逆境商量表、患者一般资料调查表和患者自我感受负担量表对天津市某三级甲等肿瘤中心303例癌症患者及中青年照顾者进行问卷调查。结果：303例中青年癌症患者照顾者逆境商得分为（129.60±21.03）分,其中,延伸维度得分最低（29.57±7.61）分;影响逆境商的因素为年龄、职业、家庭人均月收入和照顾者是否有子女（P＜0.05）;逆境商水平与患者的自我感受负担呈负相关（P＜0.05）;其中患者的情感因素与照顾者的逆境商水平联系更为密切（r=-0.434）。结论：中青年癌症患者照顾者逆境商与患者的自我感受负担呈负相关,应根据相关因素对此人群开展针对性的干预策略,提高其应对逆境的能力,进而降低患者的自我感受负担,构建和谐的医患关系。     

家庭赋权方案对首发脑卒中患者主要照顾者的影响研究

目的 探讨家庭赋权方案对提高首发脑卒中患者主要照顾者综合照顾能力及照顾准备度的效果。 方法 选择2017年1月—7月在杭州市某三级甲等医院神经内科住院的首发脑卒中患者的主要照顾者64名作为研究对象,按不同病区分为试验组和对照组,试验组33名,对照组31名。试验组接受家庭赋权方案干预和常规护理,对照组接受常规护理,应用脑卒中照顾者综合照顾能力评估问卷和照顾者准备度量表评价干预效果。 结果 干预前两组一般资料、主要照顾者综合能力各维度得分及总分和照顾者准备度得分比较,差异无统计学意义（P＞0.05）,干预后两组的综合照顾能力总分及各维度得分、照顾者准备度得分比较,差异有统计学意义（P＜0.05）。 结论 家庭赋权方案能有效提高首发脑卒中患者主要照顾者的综合照顾能力及照顾准备度,使脑卒中主要照顾者在促进患者疾病康复中起到积极作用。     

家庭赋权方案对行减重代谢术患者主要照顾者的影响

目的 探讨家庭赋权方案对行减重代谢术治疗患者的主要照顾者的综合照顾能力及照顾准备度的影响。方法 采用便利抽样法,选取2020年6月至2021年6月在厦门市某医院普外科住院行减重代谢术治疗的患者的主要照顾者为研究对象,根据患者入院先后顺序将2020年6-12月入院患者的主要照顾者纳入对照组,将2021年1-6月入院患者的主要照顾者纳入观察组,各32例。对照组接受常规健康教育,观察组接受家庭赋权方案干预,于干预前、干预后采用家庭照顾者照顾能力量表、照顾者准备度量表对两组患者主要照顾者的综合照顾能力、照顾者准备度进行评价。结果 干预后观察组照顾者综合照顾能力总分低于对照组照顾者得分,其准备度得分高于对照组得分,差异均具有统计学意义（P<0.05）。结论 家庭赋权方案能提高减重代谢术后患者主要照顾者的照顾准备度及综合照顾能力,使减重代谢术后患者照顾者在患者居家康复、术后长期的体重管理、提高患者生活质量中起到积极作用。     

长期透析患者主要照顾者照顾性行为现状的调查

目的调查血液透析患者的主要照顾者的照顾性行为现状。方法选择2010年4—9月期间任意1周,在大连市三级医院血液透析室进行血液透析患者的主要照顾者为研究对象,应用血液透析患者主要照顾者照顾性行为评估量表（LC—GADs）中文版对300名血液透析患者主要照顾者进行调查。结果300名血液透析患者主要照顾者在抽象行为分量表（Think—LC—GADs）平均得分为（3．05±0．52）分,其中评估方面得分最高为（3．28±0．35）分,指导方面得分最低为（2．65±0．36）分;在可见行为分量表（Task．LC．GADs）平均得分为（3．65±0．45）分,其中协助饮食和症状缓解两方面得分最高,分别为（3．88±0．28）分和（3．86±0．27）分;在提供交通设施方面的得分相对较低为（3．32±0．38）分。照顾性行为与主要照顾者的年龄、职业状况、婚姻状况、与患者的关系、照顾年限及每天照顾时间、是否利用收费性护理服务及家庭月收入相关（P〈0．05）。结论血液透析患者的主要照顾者承担的照顾活动较多,该群体应引起社会的广泛关注。     

脑卒中患者主要照顾者心理一致感现状及影响因素分析

目的调查脑卒中患者主要照顾者心理一致感现状,并探讨其影响因素。方法2021年6—10月,选取某三甲医院神经内科住院的238例脑卒中患者照顾者,采用Barthel指数评分量表、心理一致感量表及照顾准备度量表进行问卷调查。结果照顾者心理一致感得分为57.35±10.47分,照顾准备度得分为21.07±5.16分,Barthel指数得分为64.77±29.31分。单因素分析结果表明,不同患病次数、照顾者性别、年龄、人均月收入、文化程度、与患者关系和照顾时间心理一致感得分比较,差异有统计学意义(P<0.05)。多因素线性回归分析显示,患病次数、巴氏指数、人均月收入、与患者关系及照顾准备度是照顾者心理一致感的主要影响因素(P<0.05)。结论照顾者心理一致感得分有待提高,处于中等偏下水平;患病次数、患者自理能力、人均月收入、与患者关系及照顾准备度是照顾者心理一致感的主要影响因素。     

93例人工耳蜗植入患儿主要照顾者准备度现状及影响因素分析

目的 调查人工耳蜗植入患儿主要照顾者准备度现状,并探讨相关影响因素。方法 采用方便抽样法,选取2018年2月—2019年6月在湖北省某三级甲等医院行人工耳蜗植入术的93例患儿主要照顾者作为研究对象,采用一般资料调查问卷、主要照顾者准备度量表对其进行调查。采用多元线性回归分析人工耳蜗植入患儿主要照顾者准备度的影响因素。结果 人工耳蜗植入患儿主要照顾者准备度总分（24.32±3.11）分,多元线性回归分析结果显示：文化程度、有无共同照顾者和是否接受过听力障碍照护培训进入回归方程（P<0.05）,共解释人工耳蜗植入患儿主要照顾者准备度总变异的41.8%。结论 人工耳蜗植入患儿主要照顾者准备度处于中等水平,文化程度、有无共同照顾者和是否接受过听力障碍照护培训是其主要影响因素。建议护理人员重点关注文化程度低、无共同照顾者及未接受过听力障碍照护培训的人工耳蜗植入患儿主要照顾者,及时评估主要照顾者的照顾准备度情况,根据人群特点制定个性化的照顾方案,实施针对性地健康教育宣教,以帮助他们尽快适应人工耳蜗患儿术后不同时期的主要照顾者角色,减轻自身照护压力。     

自我效能、相依关系在脑卒中患者照顾者照顾准备度与照顾压力间的链式中介作用

目的 探讨自我效能、相依关系在脑卒中患者照顾者照顾准备度和照顾压力间的中介作用。方法 采用方便抽样法,选取2022年6月-9月河南省某三级甲等综合医院神经内科收治的252例脑卒中患者的照顾者为研究对象,应用一般资料调查表、照顾者准备度量表、照顾者压力量表、相依关系量表及照顾者自我护理贡献自我效能量表对其进行问卷调查。结果 脑卒中患者照顾者照顾压力得分为(9.12±2.13)分,相依关系得分为(39.08±2.96)分,照顾准备度得分为(20.59±2.12)分,自我效能得分为(74.53±5.25)分。照顾压力与照顾准备度、自我效能、相依关系均呈负相关(r=-0.655、-0.585、-0.548,均P<0.01),照顾准备度与自我效能、相依关系均呈正相关(r=0.750、0.631,均P<0.01)。照顾准备度可直接影响照顾压力,还可通过自我效能、相依关系及自我效能和相依关系的链式中介作用对照顾压力产生影响,其中介效应值分别为-0.092、-0.070、-0.039。结论 自我效能和相依关系在脑卒中患者照顾者照顾准备度与照顾压力间起链式中介作用。医护人员应主动提供针对性教...     

化疗期间胃癌患者家庭照顾者照顾准备度与支持性照护需求关系的纵向研究

目的 调查胃癌患者家庭照顾者支持性照护需求水平在化疗期间的动态变化，分析支持性照护需求的影响因素。方法 便利抽样法选择河南省肿瘤医院收治的209例胃癌患者的家庭照顾者为研究对象，采用一般情况调查表、癌症患者照顾者支持性照护需求量表、照顾者准备度量表，分别于化疗前1 d、第1次、第3次及第6次化疗对其进行调查。结果 胃癌患者家庭照顾者的支持性照护需求在化疗期间呈先上升后下降的趋势(F=103.036,P<0.01),其中在第1次化疗时得分最高(P<0.01);照顾准备度与不同时间点支持性照护需求均呈负相关(r为-0.358～-0.523,均P<0.01)。广义估计方程结果显示，与患者是子女关系、高经济负担的照顾者会增加支持性照护需求，而较高的照顾准备度可降低其支持性照护需求(均P<0.05)。结论 胃癌家庭照顾者化疗期间支持性照护需求水平呈动态变化，应提升照顾者的照顾准备度，以改善其支持性照护需求状况。     

肝硬化失代偿期病人主要照顾者准备度现状及影响因素分析

[目的]了解肝硬化失代偿期病人主要照顾者准备度现状,分析其影响因素。[方法]2018年10月—2019年6月于某三级甲等医院消化内科2个病区采取方便抽样的方法收集肝硬化失代偿期病人主要照顾者,使用一般资料问卷和照顾者准备度问卷进行调查。[结果]肝硬化失代偿期病人照顾者准备度总得分为(17.12±1.71)分,多元线性回归分析结果表明,日承担照顾时间、月收入、与病人关系、照顾经历、有无共同照顾者、病人年龄、肝功能分级是照顾者准备度得分的影响因素。[结论]肝硬化失代偿期病人的照顾者应重点关注,特别是对于收入少、文化程度低、照顾时间长、无共同照顾者、照顾经历少的照顾者付出更多的耐心和指导,使照顾者可以更好地适应角色。     

The association of collaboration between family caregivers and nurses in the hospital and their preparedness for caregiving at home

Family caregivers of an older person who was recently hospitalized often feel unprepared for their new or expanded tasks. Quality and continuity of care for older people is expected to improve when nurses collaborate with family caregivers as partners in care. The aim of this study was to explore the unique contribution of collaboration between family caregivers of older patients and hospital nurses as a possible predictor for preparedness of caregiving after hospital discharge. With a cross sectional design, a postal survey was sent to 777 family caregivers of home-dwelling hospitalized patients (≥70 years). Regression analyses were used to test the association between collaboration and preparedness for caregiving. In total, 506 (68%) family caregivers responded of whom 281 (38%) were eligible. Their mean (SD) age was 65 (13) and 71% were female. Family caregivers’ level of collaboration with nurses was significantly associated with their preparedness for caregiving.     

Preparing family caregivers for death and bereavement. Insights from caregivers of terminally ill patients

Many family caregivers are unprepared for the death of their loved one and may suffer from worse mental health as a result. We therefore sought to determine the factors that family caregivers believe are important to preparing for death and bereavement. Focus groups and ethnographic interviews were conducted with 33 family caregivers (bereaved or current) of terminally ill patients. The interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Life experiences such as the duration of caregiving/illness, advance care planning, previous experiences with caregiving or death, and medical sophistication all impacted preparedness, or the degree to which a caregiver is ready for the death and bereavement. Regardless of life experiences, however, all caregivers reported medical, practical, psychosocial, and religious/spiritual uncertainty. Because uncertainty was multidimensional, caregivers often needed more than prognostic information in order to prepare. Communication was the primary mechanism used to manage uncertainty. Good communication included clear, reliable information, combined with relationship-centered care from health care providers. Finally, preparedness had cognitive, affective, and behavioral dimensions. To prepare, some caregivers needed information tailored to their uncertainty (cognitive), others needed to "mentally" or "emotionally" prepare (affective), and still others had important tasks to complete (behavioral). In order to better prepare family caregivers for the death of a loved one, health care providers must develop a trusting relationship with caregivers, provide them with reliable information tailored to their uncertainty, and allow time for caregivers to process the information and complete important tasks.     

老年肺癌患者首次化疗后出院准备度现状及影响因素分析

目的:对老年肺癌患者首次化疗后出院准备度现状进行调查,并分析其影响因素,为提高此类患者出院准备度提供理论依据.方法:采用一般资料问卷、出院准备度评估量表对天津市某三级甲等医院呼吸内科150例首次化疗的老年肺癌患者进行调查.结果:150例首次化疗的老年肺癌患者出院准备度总分为(87.62±16.39)分.多元回归分析显示...     

Quality of life and satisfaction with care among family caregivers of patients with recurrent or metastasized digestive cancer requiring palliative care

Purpose

Satisfaction with care is thought to be important for quality of life (QOL) of family caregivers of patients with recurrent or metastasized digestive cancer requiring palliative care. This study aimed to clarify (1) family caregivers’ QOL status and (2) factors related to their QOL, including satisfaction with care.

Methods

Data were collected from 111 family caregivers of patients with recurrent or metastasized digestive cancer. The Short-Form 36 (SF-36) (acute version) was used to measure QOL.

Results

Family caregivers’ QOL was lower than the national average (Cohen’s d?=?0.12–0.66). Lower age of patients and family caregivers (standardized regression coefficient (β)?=??0.18, β?=??0.26) and family caregivers’ perceived health (β?=?0.22) were related to better physical health of family caregivers, but satisfaction with care was not related to physical health. However, family caregivers’ mental health was related to their satisfaction with care (Spearman’s rank correlation coefficient (r)?=?0.49–0.61, standardized regression coefficient (β)?=?0.24–0.42), as well as higher age of family caregivers (β?=?0.25), their perceived health (β?=?0.30), non-spousal caregiver (β?=??0.20), patient lacking a history of surgery aimed at radical treatment (β?=??0.22), and patient not hospitalized solely for symptom relief (β?=??0.10).

Conclusions

Family caregivers of patients with recurrent or metastasized digestive cancer requiring palliative care had lower QOL, both physically and mentally, than the national average. Improvements in satisfaction with care may contribute to improved QOL.     

老年性痴呆患者亲属照料负担与心理健康的相关性分析

目的；了解老年性痴呆患者家庭照料者的照料负担和心理健康状况，提高患者的家庭照料质量和延缓疾病进程，为社区心理卫生服务提供目标依据。方法；采用自编一般情况问卷表、照料负担量表（BCS）、照料者生活变化问卷及90项症状清单量表（SCL-90）对275例老年性痴呆患者的家庭照料者进行问卷调查。结果：共216位照料者接受调查。BCS及照料者生活变化问卷测评显示，老年性痴呆患者的照料负担依次为经济负担〉心理健康〉家庭生活〉家庭关系〉躯体健康〉家庭活动。SCL-90测评显示照料者心理健康水平均有不同程度下降，且照料负担与SCL-90总分呈正相关性，提示家庭照料负担越重，对照料者心理健康影响越大。结论；医生应帮助照料者认识该病，了解照料技巧，适应生存环境及改善其负性心理；同时加强对社区内老年性痴呆疾病的健康宣教，提高收治率，以解决照料者的后顾之忧。     

癌症患者亲属的焦虑、抑郁状况及相关因素研究

目的了解癌症患者主要照顾亲属的焦虑、抑郁状况及相关影响因素。方法采用CESD量表、SAS量表及一般情况调查表对106例住院癌症患者的主要照顾亲属进行问卷调查。结果106例癌症患者亲属的抑郁自评分为（18．75±9．06）分,高于国内常模,差异有统计学意义（P〈0．01）;55．7％的亲属存在抑郁症状;焦虑自评分为（33．94±7．09）分,高于国内常模,差异有统计学意义（P〈0．01）;22．6％的亲属存在焦虑症状;患者的配偶和患者躯体症状较多的亲属更易发生焦虑。结论癌症患者的主要照顾亲属存在较严重的焦虑、抑郁情绪,其心理健康状况受多种因素影响,医务人员应积极采取针对性的干预措施,提高患者亲属的心理健康水平。     

Information needs and the related variables of Japanese family caregivers of terminally ill cancer patients

The present study examined the information needs of family caregivers of terminally ill cancer patients. Data were obtained by a structured interview from 66 Japanese caregivers of cancer patients institutionalized in a palliative care unit. Needs for disease-related information (the disease, treatment and prognosis) and care-related information (the care for the patient and family members) were investigated, and demographic and situational characteristics related to individual information needs were assessed. More than 60% of family caregivers wanted disease-related information, and approximately half of these wanted patient and family care-related information. These information needs had significant correlations with the family caregiver's age and with such patient-dependent situational variables as time since diagnosis, care site before enrolling in a palliative care unit, and presence or absence of other family caregivers. The results may help health care professionals to better inform terminally ill cancer patients and their family caregivers.     

Outcomes for family carers of a nurse-delivered hospital discharge intervention for older people (the Further Enabling Care at Home Program): Single blind randomised controlled trial

BackgroundHospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers’ self-identified support needs.ObjectivesThis study tested the hypothesis that the extent to which family caregivers of older people discharged home from hospital felt prepared to provide care at home would be positively influenced by their inclusion in the new Further Enabling Care at Home program.DesignThis single-blind randomised controlled trial compared outcomes from usual care alone with those from usual care plus the new program. The program, delivered by a specially trained nurse over the telephone, included: support to facilitate understanding of the patient’s discharge letter; caregiver support needs assessment; caregiver prioritisation of urgent needs; and collaborative guidance, from the nurse, regarding accessing supports.Setting and participantsDyads were recruited from the medical assessment unit of a Western Australian metropolitan public hospital. Each dyad comprised a patient aged 70 years or older plus an English speaking family caregiver.MethodsThe primary outcome was the caregiver’s self-reported preparedness to provide care for the patient. Data collection time points were designated as: Time 1, within four days of discharge; Time 2, 15–21 days after discharge; Time 3, six weeks after discharge. Other measures included caregivers’ ratings of: their health, patients’ symptoms and independence, caregiver strain, family well-being, caregiver stress, and positive appraisals of caregiving. Data were collected by telephone.ResultsComplete data sets were obtained from 62 intervention group caregivers and 79 controls. Groups were equivalent at baseline. Needs prioritised most often by caregivers were: to know whom to contact and what to expect in the future and to access practical help at home. Support guidance included how to: access help, information, and resources; develop crisis plans; obtain referrals and services; and organise legal requirements.Compared to controls, preparedness to care improved in the intervention group from Time 1 to Time 2 (effect size = 0.52; p = 0.006) and from Time 1 to Time 3 (effect size = 0.43; p = 0.019). These improvements corresponded to a change of approximately 2 points on the Preparedness for Caregiving instrument. Small but significant positive impacts were also observed in other outcomes, including caregiver strain.ConclusionsThese unequivocal findings provide a basis for considering the Furthering Enabling Care at Home program’s implementation in this and other similar settings. Further testing is required to determine the generalisability of results.