Stress in the caregivers of Alzheimer's patients: an experimental investigation in Italy.
Stress in the caregivers of Alzheimer's patients: an experimental investigation in Italy.
复制标题
DOI：
10.1177/153331750401900403
复制
发表时间：
2004-07-01
期刊：
影响因子：
--
通讯作者：
Maso, E
中科院分区：
文献类型：
--
作者：
Aguglia, E;Onor, M L;Maso, E
在意大利，家庭是满足不再能够自给自足的老年人需要的主要手段。这些照顾者通常是妻子或女儿，他们选择将病人留在家里。平均而言，护理人员一天中有四分之三的时间用于照顾病人，这一比例往往随着疾病的进展而线性增加。我们研究的主要目的是描述一组诊断为痴呆症患者的意大利护理人员，以评估他们的压力水平。然后，我们将这些照顾者与一些社会人口学变量以及患者的认知障碍程度和日常生活活动的独立性相关联。研究对象为236名根据DSM-IV诊断标准诊断为阿尔茨海默病（AD）的患者的照顾者。每个照顾者都参加了一个社会人口学访谈，并填写了两份问卷：照顾者负担清单（CBI），量化的工作量和简短的症状清单（BSI），以评估焦虑和抑郁的水平。对患者进行简易精神状态检查（MMSE）以评估其认知障碍水平，并进行工具性日常生活活动（IADL）和日常生活活动（ADL）测试以量化其独立性水平。结果分析显示，意大利AD患者的平均护理者是女性，年龄约60岁。大多数照顾者是配偶，其次是子女。一般来说，这些照顾者在家工作，是家庭主妇或退休人员，亲自参与照顾病人。患者的认知障碍程度越高，他们的独立性越差，他们需要的护理和监督就越多，留给护理人员的空闲时间就越少;这导致了更高水平的与焦虑相关的焦虑。在疾病的最后阶段，病人的护理任务几乎占据了护理人员所有的空闲时间，每周只给他们自己或朋友留下大约两个小时。总之，痴呆症患者的管理给护理人员带来了特别的负担，并涉及若干经济和社会成本。随着疾病的进展，负担变得更重，因为认知障碍的增加和由此导致的日常生活独立性的降低，以及行为症状的出现，加剧了照顾者的痛苦、焦虑和抑郁。因此，建立一个能够减轻家庭负担的社区服务网络是一个优先事项。记录的美国护理人员和意大利护理人员的压力之间可以得出相似之处。
In Italy, the family constitutes the major caregiving response to the needs of the elderly who are no longer self-sufficient. These caregivers are often wives or daughters who have chosen to keep the patient at home with them. On average, three-quarters of the caregiver's day is devoted to the patient, a proportion that tends to increase linearly as the disease progresses. The primary aim of our study was to describe a group of Italian caregivers of patients with a diagnosis of dementia to assess their levels of stress. We then correlated these caregivers with a number of sociodemographic variables and the patients' degree of cognitive impairment and independence in daily life activities. The study was conducted on a sample group of 236 caregivers of patients with a diagnosis of Alzheimer's disease (AD) according to the DSM-IV criteria. Each caregiver took part in a sociodemographic interview and filled in two questionnaires: the Caregiver Burden Inventory (CBI), to quantify the caregiving workload and the Brief Symptom Inventory (BSI), to assess the level of anxiety and depression. Patients were administered the Mini-Mental State Examination (MMSE) to evaluate their level of cognitive impairment and the Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) tests to quantify their level of independence. The analysis of the results shows that the average Italian caregiver of an AD patient is a woman, approximately 60 years old. The majority of caregivers are spouses, followed by children. In general, these caregivers work at home, are housewives or retired, and are personally involved in caring for the patients. The greater the level of a patient's cognitive impairment and the less independent they are, the greater amount of care and supervision they require, leaving less free time for the caregiver; this leads to higher levels of anxiety related to caregiving. Toward the final stages of the disease, patient care tasks take up nearly all of the caregiver's free time, leaving them only about two hours per week for themselves or their friends. In conclusion, the management of dementia patients places a particular burden on the caregiver and involves several economic and social costs. The burden becomes heavier as the disease progresses, since the increase of cognitive disorders and the resulting reduction of independence in daily life, together with the onset of behavioral symptoms, heighten the caregiver's distress, anxiety, and depression. Establishing a network of community services able to alleviate the burden on families is therefore a priority. Parallels can be drawn between the stresses documented for American caregivers and their Italian counterparts.