Family caregiving of individuals with traumatic brain injury in Botswana
Family caregiving of individuals with traumatic brain injury in Botswana
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DOI：
10.3109/09638288.2016.1152605
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发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Ponsford, Jennie
中科院分区：
文献类型：
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作者：
Mbakile-Mahlanza, Lingani;Manderson, Lenore;Ponsford, Jennie
创伤性脑损伤幸存者的损伤会影响他们的独立性，家庭成员经常需要承担照顾者的角色。本研究探讨了博茨瓦纳TBI患者的康复经验及其对护理人员心理困扰的影响。方法采用混合方法研究设计，半结构化访谈的定性数据进行了专题分析，并与结构化头部损伤结局问卷和医院焦虑和抑郁量表（HADS）的功能状态数据进行三角分析。结果26例中重度TBI患者共纳入18名照顾者。照顾者通常报告说，他们收到的关于亲属受伤和管理方法的信息有限。对他们提出了沉重的医疗要求，而医疗系统几乎没有提供支持。一个显着比例的照顾者经历了焦虑和抑郁，这是与较低的功能独立性在他们受伤的亲属。有些配偶比父母报告临床显着的焦虑水平。隔离的其他后果包括社会孤立和更广泛社区的支持有限以及经济困难。尽管有这些压力，照顾者倾向于接受他们的照顾角色。文化因素，如对家庭的奉献和对上帝的信仰减轻了负担和痛苦。博茨瓦纳TBI患者的护理人员面临着重大挑战。重建工作必须考虑到这些因素。具体而言，需要向幸存者及其家人提供更多的信息和支持。在规划康复干预措施时，还应考虑到护理提供者的心理、经济和健康需求。
Background The impairments that affect survivors of TBI impact the person's independence, and family members frequently have to take on a caregiver role. This study examined the experience of caregiving for individuals with TBI in Botswana and its impact on psychological distress in caregivers. Methods Using a mixed methods study design, qualitative data from semi-structured interviews were thematically analyzed and triangulated with data regarding functional status from the Structured Head Injury Outcome Questionnaire and the Hospital Anxiety and Depression Scale (HADS). Results The study included 26 participants with moderate to severe TBI, and a total of 18 caregivers were recruited. Caregivers commonly reported receiving limited information regarding their relatives' injuries and management methods. Heavy caregiving demands were placed on them, with little support from the healthcare system. A significant proportion of caregivers experienced anxiety and depression, which was associated with lower functional independence in their injured relative. Somewhat more spouses than parents reported clinically significant anxiety levels. Other consequences of caregiving included social isolation and limited support from the wider community as well as financial difficulties. Despite these stresses caregivers tended to accept their caregiving role. Cultural factors such devotion to their families and faith and belief in God moderated burden and distress. Conclusions Carers of individuals with TBI in Botswana face significant challenges. Rehabilitation efforts need to take these into account. Specifically, more information and support needs to be provided to survivors and their families. Psychological, economic and health needs of the care providers also should be addressed in the planning of rehabilitation interventions.