Long-term care placement of dementia patients and caregiver health and well-being
Long-term care placement of dementia patients and caregiver health and well-being
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DOI：
10.1001/jama.292.8.961
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发表时间：
2004-08-25
影响因子：
120.7
通讯作者：
Zhang, S
中科院分区：
文献类型：
--
作者：
Schulz, R;Belle, SH;Zhang, S
在护理人员中，将患有痴呆症的亲属送入长期护理机构是很常见的。安置过渡和因素，影响护理人员的健康和福祉安置后的病人没有很好地描述。目的评估将患有痴呆症的亲属安置在长期护理机构对照顾者健康和福祉的影响。设计、设置和参与者：从1996年到2000年的前瞻性研究，从美国6个地点招募了1222名护理者和患者。在18个月的随访期间，共有180名患者被安置在长期护理机构。对安置前后收集的数据进行分析，以确定与安置相关的因素，安置后照顾者与其机构亲属之间的联系性质，以及这两种因素与痴呆照顾者健康结果的关系。护理者抑郁（流行病学研究中心抑郁量表[CES-D]上的症状，范围0-60）和焦虑（状态特征量表，范围10-40）以及使用治疗抑郁和焦虑的处方药。结果将其亲属送院的护理人员报告的抑郁症状和焦虑程度与在家护理人员一样高。受试者抑郁的总体CES-D评分与放置前后无显著差异（中位数[IQR]、15.0[8-24.5]和15.0 [7.7-28]；P= 0.64）。状态特质量表的总体焦虑得分也没有显著变化（中位数[IQR]，前22.0 (19-27)vs后21.1 [18-27]；P=.21）。这些影响在与患者结婚的护理人员中最为明显（对于抑郁症，P= 0.02），更频繁地访问患者（对于抑郁症，P= 0.01）
Context Placing a relative with dementia into a long-term care facility is common among caregivers. Placement transition and factors that affect caregiver health and well-being after placement of the patient are not well described.Objective To assess the impact of placing a relative with dementia in a long-term care facility on caregivers' health and well-being.Design, Setting, and Participants Prospective study from 1996 to 2000 of the placement transition in a sample of 1222 caregiver-patient dyads recruited from 6 US sites. A total of 180 patients were placed in a long-term care facility during the 18-month follow-up period. Data collected before and after placement were analyzed to identify factors associated with placement, the nature of contact between caregivers and their institutionalized relatives after placement, and the relation of both of these factors to health outcomes among dementia caregivers.Main Outcome Measures Caregiver depression (symptoms on the Center for Epidemiological Studies-Depression [CES-D] scale; range, 0-60) and anxiety (State Trait Inventory; range, 10-40) and use of prescription medications for depression and anxiety.Results Caregivers who institutionalized their relative reported depressive symptoms and anxiety to be as high as they were while in-home caregivers. Overall CES-D scores for depression did not change from before to after placement (median [IQR], 15.0 [8-24.5] and 15.0 [7.7-28]; P=.64). Overall anxiety scores on the State Trait Inventory also did not change significantly (median [IQR], 22.0 (19-27] before vs 21.1 [18-27] after; P=.21). These effects were most pronounced among caregivers who were married to the patient (P=.02 for depression), visited more frequently (P=.01 for depression and P