Humanistic burden among caregivers of patients with Alzheimer's disease or dementia in Japan: a large-scale cross-sectional survey
Humanistic burden among caregivers of patients with Alzheimer's disease or dementia in Japan: a large-scale cross-sectional survey
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DOI：
10.1080/13696998.2021.1877149
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发表时间：
2021-01-01
影响因子：
2.4
通讯作者：
Tsukamoto, Katsura
中科院分区：
文献类型：
--
作者：
Ohno, Shinya;Chen, Yirong;Tsukamoto, Katsura
目的随着日本人口的快速老龄化，痴呆症，特别是阿尔茨海默病（AD）的患病率预计将增加，导致对护理人员的需求不断增长。本研究旨在量化并比较日本AD/痴呆患者照顾者与其他疾病患者照顾者的人文负担。材料和方法本横断面研究使用了2018年日本国家健康和保健调查（NHWS）的数据。结果测量包括健康相关生活质量（HRQoL）的简短12项健康调查（SF-12），健康状态效用、健康对生产力和活动的影响的EuroQol 5维量表（EQ-5D），以及抑郁和焦虑的评估。多变量分析用于组间比较，并对潜在的混杂效应进行调整。结果共确定AD/痴呆患者照顾者805人，其他照顾者1099人，非照顾者27137人。阿尔茨海默病/痴呆症护理人员和其他护理人员的HRQoL和EQ-5D评分都较低，总活动障碍较高，护理人员比非护理人员更容易感到焦虑。阿尔茨海默病/痴呆护理者与其他疾病护理者在基本和辅助日常生活活动（ADL）参与方面无显著差异。值得注意的是，阿尔茨海默病/痴呆症护理人员比其他护理人员更多地参与制定治疗决策和财务管理。在照顾一名患者的阿尔茨海默病/痴呆症护理人员中，395名患者住在社区，282名住在机构。居住在社区的AD/痴呆护理人员更显著地参与基本和工具性ADL。同时患有阿尔茨海默病/痴呆和癌症的患者的照顾者比任何一种情况的患者的照顾者有更高的照顾负担。结论据报道，日本老年痴呆症患者的护理人员承受着显著的人文负担，这与患者的生活安排和其他慢性疾病的存在有关。因此，提供有效的护理/支持对于减轻照顾者的负担至关重要。
AimsAs the population in Japan is rapidly aging, the prevalence of dementia, particularly Alzheimer's Disease (AD), is expected to increase, resulting in a growing need for caregivers. This study aims to quantify and compare the humanistic burden of caregivers of AD/dementia patients with caregivers of patients with other conditions in Japan.Materials and methodsThis cross-sectional study used data from the 2018 Japan National Health and Wellness Survey (NHWS). Outcome measures included the Short-Form 12-item Health Survey (SF-12) for health-related quality-of-life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, impact of health on productivity and activity, and evaluation of depression and anxiety. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects.ResultsA total of 805 caregivers of AD/dementia patients, 1,099 other caregivers, and 27,137 non-caregivers were identified. Both AD/dementia caregivers and other caregivers had lower HRQoL and EQ-5D scores, higher total activity impairment, and more caregivers tended to experience anxiety than non-caregivers. There were no significant differences in the involvment in basic and instrumental activities of daily living (ADL) between AD/dementia caregivers and caregivers of other conditions. Notably, AD/dementia caregivers were more involved in making treatment decisions and finance management than other caregivers. Among AD/dementia caregivers caring for one patient, 395 patients lived in the community and 282 in an institution. AD/dementia caregivers whose patients lived in the community were more significantly involved in basic and instrumental ADL. Caregivers of patients with both AD/dementia and cancer had higher caregiving burden than caregivers of patients with either condition.ConclusionsCaregivers of AD/dementia patients in Japan reportedly experienced significant humanistic burden which is associated with patients' living arrangements and the presence of an additional chronic condition. Therefore, provision of effective care/support is essential to relieve the burden experienced by the caregivers.