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。     

老年肠造口患者主要照顾者社会支持、心理韧性与照顾负担的相关性

目的探讨老年肠造口患者主要照顾者社会支持、心理韧性及照顾负担的现状及相关性。方法采用一般资料调查表、社会支持量表(SSRS)、心理韧性量表(PCQ)及Zarit照顾负担量表(ZBI)对苏州大学附属第一医院行肠造口手术后的老年患者的主要照顾者进行调查。结果老年肠造口患者主要照顾者SSRS总分(38.50±14.47)分,PCQ总分(126.00±75.60)分,ZBI总分(57.45±22.34)分,老年肠造口患者主要照顾者的SSRS、PCQ及ZBI总分及各维度得分显示三者之间均有显著相关性,心理韧性在社会支持和照顾负担中起部分中介作用,中介效应是30.18%。结论老年肠造口患者主要照顾者的社会支持、心理韧性及照顾负担之间两两相关,老年肠造口患者主要照顾者不仅可以通过社会支持来直接影响照护水平,还可以通过心理韧性的中介作用对照护水平产生间接影响。     

老年期痴呆患者照顾者的照顾感受

目的探究老年期痴呆患者照顾者照顾感受水平及影响因素。方法采用一般情况问卷、Zarit照顾者负担量表(ZBI)和照顾者积极感受量表对153例老年期痴呆患者及其照顾者进行调查,并进行统计学分析。结果老年期痴呆患者照顾者照顾负担的总分为(38.25±14.29)分,积极感受总分为(32.18±8.12)分,多元回归分析结果表明,照顾者自觉经济压力、家中分担照顾人数、照顾者自觉健康状况、每日照顾小时数为照顾负担的影响因素,目前与患者的情感关系、"放入养老机构照顾"想法的频率、患者性别、患者医疗费用支付方式、成为照顾者的动机为积极感受的影响因素。结论完善社区卫生服务体系,加强家庭照顾与社会正式支持的有效结合,在护理实践中,在关心痴呆患者的同时,也应该关心照顾者,应从消极与积极两个方面全面真实理解照顾者照顾感受,给予针对性的护理服务与指导,以达到减轻照顾者照顾负担、改善其身心健康的目的。     

脑卒中患者主要照顾者生活质量及相关因素

目的探讨脑卒中患者主要照顾者生活质量及其影响因素。方法选取河南省开封市某三级甲等医院273例脑卒中患者主要照顾者,研究内容包括:主要照顾者基本资料、Zarit护理负担量表、生存质量测定量表简表。结果主要照顾者性别、年龄、文化程度、与患者关系和Zarit护理负担量表得分对生活质量的四个领域分别有不同程度的影响;患者性别、年龄、生活方式和美国国立卫生研究院脑卒中量表(NIHSS)评分对生活质量的四个领域有不同程度的影响。多重线性回归分析显示,主要照顾者文化程度、年龄和Zarit护理负担量表得分及患者性别、NIHSS评分与主要照顾者生活质量评分相关联。结论护理人员应了解影响脑卒中患者主要照顾者生活质量的相关因素,提出有效护理措施改善其生活质量。     

居家老年期痴呆患者照顾者的感受

目的研究居家老年期痴呆者照顾者的照顾负担和积极感受。方法采用一般情况问卷、照顾者负担量表、照顾者积极感受量表对71例照顾者进行量性研究;质性研究是对9例照顾者采用非结构式访谈。结果照顾者的负担总分(53.76±12.41)分,积极感受总分(27.15±5.32)分,均属中等程度;质性研究提炼出4个主题:无法接受现实,身心俱疲;自我调整,寻找新的生活平衡;多方学习,努力照顾好亲人;坦然面对,不离不弃,相伴永远。结论照顾者存在中等负担与积极感受两个不容忽视的问题,应采取积极有效的措施,减轻其负担,增强积极感受,提高生活质量。     

老年慢性病照顾者负担与社会支持的关系

目的探讨老年慢性病照顾者的照顾负担现状、社会支持情况及两者之间的关系。方法利用老年慢性病照顾者的一般资料调查表,照顾者负担量表(ZBI)、社会支持评定量表(SSRS)分别对122例符合纳入标准的老年慢性病主要照顾者进行调查。结果老年慢性病患者主要照顾者的负担总分为(35.60±15.67)分。社会支持分数为(27.94±6.55)分,其中主观支持得分(12.44±4.47)分,客观支持(8.52±2.84)分,支持利用度(6.97±2.04)分。ZBI得分与客观支持、社会支持总分均呈负相关(P0.05)。结论老年慢性病患者照顾者存在不同程度的照顾负担,完善的社会支持系统可以减轻家庭照顾者的负担。     

首发老年脑卒中患者出院过渡期家庭主要照顾者照顾能力现状及影响因素

目的探讨首发脑卒中患者出院过渡期家庭主要照顾者照顾能力现状及影响因素。方法采用一般情况调查表、中文版家庭照顾能力(FCTI)量表、脑卒中知识问卷调查表,对2017年6月至2018年2月泰州市第二人民医院神经内科220例首发脑卒中患者及其家庭主要照顾者进行调查研究。结果首发脑卒中患者出院过渡期家庭主要照顾者照顾能力总分为(16.43±4.27)分,各维度得分由高到低分别为应变并为患者提供协助[(4.24±2.55)分]、调整自我生活以满足照顾需求[(3.97±2.68)分]、评估家人及社区资源[(3.59±2.68)分]、适应照顾角色[(3.49±2.45)分]、处理个人情绪[(2.54±1.05)分]。单因素分析结果显示,照顾者的年龄、职业、文化程度、家庭人均月收入、与患者关系、是否患有慢性病、平均每天照顾时间和患者的疾病严重程度、疾病造成的经济负担、医疗费用支付方式、所在社区是否有医疗上门服务对家庭照顾者照顾能力得分均有影响(P0.05);多元线性回归分析得出,患者的疾病严重程度、医疗支付方式、疾病造成的经济负担、所在社区是否有医疗上门服务和照顾者的年龄、文化程度、每天照顾时间、家庭人均收入、职业、是否患有慢性病、脑卒中知识和晓度是家庭照顾者照顾能力的主要影响因素(P0.05)。结论首发脑卒中患者出院过渡期家庭照顾者的照顾能力亟待提高,医护人员出院前应评估患者及照顾者具体情况,根据结果提供个性化措施,以提高患者及照顾者健康水平,减轻社会及家庭负担。     

高龄老人家庭虐待倾向与照顾负担、照顾者心境的相关性

目的分析高龄老人家庭虐待倾向、照顾负担、照顾者心境的关系。方法选取高龄老人及其主要家庭照顾者各147名,采用照顾者虐待老人评估量表、照顾负担量表、简明心境量表进行问卷调查。结果高龄老人家庭虐待倾向得分(3.43±0.23)分,存在虐待倾向。照顾者的负担总分、心境状态总分分别是(32.29±1.74)分、(114.76±2.44)分,均属于中度水平。相关分析结果表明,家庭虐待倾向、照顾负担、心境状态两两之间有显著正相关关系(P<0.01)。回归分析显示照顾负担、心境状态是家庭虐待倾向有效预测因子。结论高龄老人存在受虐问题,应给予重视。可通过心理干预、社会支持等途径减轻照顾者负担、调整照顾者心境情绪,从而降低高龄老人受虐危险。     

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。     

老年痴呆患者家庭照顾者负担与压力现状及影响因素

目的探讨老年痴呆患者家庭照顾者负担与压力现状及其影响因素。方法应用Zarit护理负担量表和照顾者压力调查量表(CSI)对212名老年痴呆患者家庭照顾者及患者进行调查研究。结果女性照顾者占总照顾者的88.2%,58.5%家庭照顾者有中等程度的负担及高压力水平(P0.05),低收入群体表现出高水平负担及高水平压力,影响负担的压力因素是个人计划改变,时间需求变化,情绪变化。结论老年痴呆家庭照顾者负担水平及压力水平相对较高,尤其是低收入群体,应采取有效干预手段进行干预,缓解生活负担及压力水平。     

Association between the caregiver's burden and physical activity in community-dwelling caregivers of dementia patients

Physical activity in the elderly has a significant influence on their health status. Studies have shown that elderly caregivers have fewer physical activities relative to non-caregivers. The present study aimed to identify factors associated with lower physical activity in elderly caregivers of demented patients. A cross-sectional survey of 50 elderly caregivers living with patients diagnosed with Alzheimer's-type dementia showed that the Zarit caregiver burden interview (ZBI) scores were significant predictors of physical activity measured by the questionnaire score (QS) of physical activities. Among the three subscales of the QS, it was only leisure time activity scores (LS) that the ZBI scores significantly predicted. The numbers of chronic diseases were associated with lower household activity scores (HS) and sport activities scores (SS). Physical activities, in particular leisure activities, were found to be inversely associated with care burden assessed by the ZBI. Interventions to increase the physical activity levels of older caregivers may improve their health status and quality of life.     

心理弹性在肺结核患者照顾者负担与生活质量间的中介效应

目的:探讨肺结核患者照顾者照顾负担、心理弹性及生活质量间的关系。方法:以2021年5—6月在河北省胸科医院住院的肺结核患者照顾者为研究对象。按本次调查最大条目数25计算,样本量为最大条目数的5～10倍,考虑20%的无效问卷,样本量估算为150～300名。最终通过整群随机抽样的方法,抽取肺结核患者照顾者200名,作为研究对象。采用一般资料问卷、照顾者负担量表、心理弹性量表、家庭照顾者生活质量量表进行调查。结果:研究最终获得200份问卷,剔除22份无效问卷后,回收有效问卷178份,有效回收率为89.0%。178名肺结核患者照顾者照顾负担得分为(36.50±12.77)分,生活质量得分为(52.74±9.46)分,心理弹性得分为(57.51±15.91)分;Pearson相关分析结果显示,照顾负担与生活质量、心理弹性呈现负相关关系(r=-0.463,P<0.001;r=-0.400,P<0.001);生活质量与心理弹性呈现正相关关系(r=0.522,P<0.001)。心理弹性在照顾负担与生活质量间发挥部分中介效应[β(95%CI)=-0.119(-0.176～-0.069)...     

The relationship of quality of life, depression, and caregiver burden in outpatients with congestive heart failure

Primary caregivers of patients with congestive heart failure withstand enormous burden, often sacrificing their own quality of life. The relationship between caregiver burden and depression and patient quality of life and depression in this setting is unknown. Fifty outpatients were prospectively administered the Minnesota Living with Heart Failure Questionnaire and Beck Depression Inventory II (BDI-II). Caregivers were administered the Zarit Caregiver Burden Interview and BDI-II. The mean quality of life score was 35, and 26% had a BDI-II score >10. The mean Zarit Caregiver Burden Interview score was 16. Minnesota Living with Heart Failure Questionnaire, BDI-II, and Zarit Caregiver Burden Interview scores were all associated with lower ejection fraction, need for hospitalization, increased number of medications, and comorbidities. Patient Minnesota Living with Heart Failure Questionnaire score correlated with patient BDI-II, caregiver BDI-II, and Zarit Caregiver Burden Interview scores. Caregiver burden score correlated with both caregiver BDI-II and patient BDI-II. Death or hospitalization at 6 months was associated with caregiver burden and depressive symptoms and with patient quality of life and depressive symptoms. Caregivers of patients with congestive heart failure experience high caregiver burden and prevalence of depressive symptoms, which are related to the patient disease burden.     

Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India

AimIn India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India.MethodsAll impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden.ResultsA total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β = 6.6; 95% CI: 2.1–11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β = 13.9; CI: 2.5–25.4).ConclusionCaregivers of older persons with multiple impairments, especially physical impairment, are vulnerable.     

The short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8): its reliability and validity

The Zarit Burden Interview (ZBI) is the instrument most widely used in North America and Europe for assessing the burden experienced by family caregivers who look after the community-residing impaired elderly. The Japanese version of the ZBI (J-ZBI) is the most widely used in Japan for the same purpose. We used data from 691 caregivers in relation to their caregiver burden with the 22-item J-ZBI. Following a factor analysis, the 8-item short version of the J-ZBI, the J-ZBI_8, was proposed with the following two factors: Personal strain (5 items) and Role strain (3 items). Cronbach's alpha of the J-ZBI_8 was 0.89, indicating the high reliability of this instrument. Pearson's correlation coefficient between J-ZBI and J-ZBI_8 was 0.93, and the same coefficient between J-ZBI_8 and item 22 (a single global burden) was 0.68. These data indicated that J-ZBI_8 had a high concurrent validity. In addition, caregivers who declared that they did not encounter any difficulties in looking after the impaired elderly had a significantly lower J-ZBI_8 score (3.45; SD = 4.57) than those who claimed that they had such difficulties (9.31; SD = 7.19) by the t-test; this indicated that J-ZBI_8 had a high construct validity. These results indicated that the short version, the J-ZBI_8, had a high reliability and validity. Therefore, the J-ZBI_8 produced results comparable to those of the full version, i.e. the J-ZBI. The shorter yet no less reliable and valid 8 item version will thus lead to easier administration of the instrument for assessing family caregiver burden in clinical settings.     

Perceived Burden of Thai Caregivers for Older Adults After Stroke

Perception of caregiver burden among stroke survivors varies based on socioeconomic and cultural backgrounds. The objectives of this study were to identify the burdens among Thai caregivers of older stroke survivors, characteristics of caregivers and severity of caregiver burden. Caregivers of older stroke survivors were randomly interviewed (March–June, 2012). Information on baseline characteristics and caregiver burden using Zarit Burden Inventory (ZBI) was collected. One hundred one participants were assessed. The mean ZBI was 21.6 ± 14.5 [95% CI, 18.7–24.8]. More than half of caregivers reported no burden (54.5%). High burdens were associated with low self-reported income, high numbers of basic activities of daily living needed and coexisting musculoskeletal conditions. The observed low degree of burden might be the result of the sociocultural view of the study participants.     

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.     

Effect of education and muscle relaxation program on anxiety,depression and care burden in caregivers of acute stroke survivors: A randomized,controlled study

This study intended to discover the effect of education and muscle relaxation (EMR) program on anxiety, depression and care burden among caregivers of acute stroke survivors.This randomized, controlled study enrolled a total of 110 caregivers of first-ever acute stroke patients, and randomly assigned to EMR (N = 55) and control (N = 55) groups. The caregivers in the EMR group received 12-month health education and progressive muscle relaxation, and those in control group were provided common rehabilitation advices. Hospital Anxiety and Depression Scale (HADS) and Zarit Caregiver Burden Scale in caregivers were evaluated at the time of patients’ discharge from hospital (M0), then at month(M) 3, M6 and M12 after the discharge.HADS-anxiety score, anxiety rate and severity were similar at M0, M3, while were reduced at M6 and M12 in EMR group compared to control group. Furthermore, HADS-depression score was similar at M0 and M3 but was decreased at M6 and M12 in EMR group compared with control group, however, there was no difference of depression rate and severity between the 2 groups at each time point. Moreover, Zarit Caregiver Burden Scale score was similar at M0 and M3, but was decreased at M6 and M12; meanwhile, degree of care burden was similar at M0, M3 and M6, but was reduced at M12 in EMR group compared to control group.EMR program decreases anxiety, depression and care burden in caregivers of acute stroke survivors, suggesting its potential in improving mental health and further promoting quality of lives in these caregivers.     

Burden on family caregivers of frail elderly persons one year after the introduction of public long-term care insurance service in the Onga District, Fukuoka Prefecture: evaluation with a Japanese version of the Zarit caregiver burden interview]

The present study was conducted to investigate the factors related to the feeling of psychological stress, called heavy burden, in caregivers who took care of frail elderly persons 1 year after the introduction of the public long-term care insurance system (i.e., kaigo hoken) in the northern part of Fukuoka Prefecture, Kyushu, Japan. Forty-seven caregivers answered a self-administered questionnaire involving the Japanese version of the Zarit Caregiver Burden Interview (ZBI) and thus described their own caregiving situation. Compared to caregivers with a light burden, heavily burdened caregivers were less likely to have time to go out without their frail elderly, but tended to spend a longer time with them in providing for their physical care. Compared with less burdened caregivers, heavily burdened caregivers tended to be concerned with what others thought or said and more likely to use a short-stay service (i.e., temporary nursing home assistance). More social services should be provided to let caregivers have their own time without caring for their patients. In addition, local governments and caremanagers should help caregivers to understand the benefits of services available for the elderly and their caregivers.