脑卒中居家主要照顾者需求及影响因素分析

目的 了解脑卒中居家主要照顾者需求现状,并分析其影响因素。方法 纳入2018年9月—2019年1月在四川大学华西医院神经内科门诊就诊的脑卒中患者及其主要照顾者298对,并收集患者及其主要照顾者一般资料,运用脑卒中居家主要照顾者需求量表评估照顾者需求。应用多因素Logistic回归分析分别探索患者、照顾者资料与照顾者需求的关系。结果 多因素分析显示患者性别（OR=0.558,95%CI：0.329~0.945）、辅助照顾者人数（OR=7.212,95%CI：1.439~36.137）、照顾者学历（OR=0.273,95%CI：0.103~0.726）是脑卒中居家主要照顾者信息需求的独立影响因素;辅助照顾者人数（OR=2.467,95%CI：1.162~5.240）、患者家庭人均月收入（OR=2.470,95%CI：1.216~5.019）、照顾者与患者的关系（OR=3.322,95%CI：1.245~8.868）是脑卒中居家主要照顾者照顾技能需求的独立影响因素;辅助照顾者人数（OR=4.497,95%CI：1.130~22.110）是脑卒中居家主要照顾者社会支持需求的独立影响因素;照顾者年龄（OR=3.348,95%CI：1.021~10.983）及辅助照顾者人数（OR=14.200,95%CI：2.521~79.988）是脑卒中居家主要照顾者整体需求的独立影响因素。结论 脑卒中居家主要照顾者需求程度由高到低排序依次为信息需求、社会支持需求、照顾者个人需求、照顾技能需求。女性患者、家庭人均月收入较高的患者、学历较高的照顾者、辅助照顾者者较多以及照顾者的子女是患者主要照顾者需求的独立影响因素。提示医护人员应重点关注此类人群,及时提供相应的服务,以期减少照顾者负担。

Needs of Main Caregivers of Home Stroke Survivors,Its Influence Factors

Objective To investigate the needs of main caregivers of home stroke patients and analyze its influence factors. Methods A total of 298 stroke patients and their main caregivers from the Department of Neurology, West China Hospital from September 2018 to January 2019 were enrolled. General information of patients and their main caregivers was collected, and the scale of main caregivers of stroke patients' needs was used to evaluate their needs. Univariate analysis was used to explore the relationship between the data of patients and caregiver and caregiver needs. Results Multivariate analysis showed patient gender (OR=0.558, 95%CI:0.329~0.945), number of assisted caregivers (OR=7.212, 95%CI:1.439~36.137) and education background of caregivers (OR=0.273, 95%CI:0.103~0.726) were independent influencing factors for the information need of the main caregivers; number of assisted caregivers (OR=2.467,95%CI:1.162~5.240), average monthly income of patients (OR=2.470,95%CI:1.216~5.019), relationship between caregrivers and the patient (OR=3.322, 95%CI:1.245~8.868) were independent influencing factors of care need of the main caregivers; number of assisted caregivers(OR=4.497,95%CI:1.130~22.110) was the independent influcencing factor of social support need of caregivers; age of the caregiver (OR=3.348, 95%CI:1.021~10.983) and number of assisted caregivers（OR=14.200,95%CI:2.521~79.988）were independent influencing factors of needs of primary caregivers. Conclusion The needs of the main caregivers of home stroke patients ranking from high to low are information need, social support need, caregivers' personal need and care skill need. Female patients, patients with higher per monthly income, well-educated caregivers, more assisted caregivers and children of caregivers are independent influencing factors of the main caregivers and medical staff should pay more attention to these groups and provide corresponding service in time so as to reduce the burden of caregivers.