Predictors of depressive symptoms in caregivers of patients with heart failure.
Predictors of depressive symptoms in caregivers of patients with heart failure.
复制标题
DOI：
10.1097/jcn.0b013e3181d2a58d
复制
发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Moser DK
中科院分区：
文献类型：
--
作者：
Chung ML;Pressler SJ;Dunbar SB;Lennie TA;Moser DK
数以百万计的家庭成员为心力衰竭患者提供非正式的护理和支持。心衰患者的护理人员患有抑郁症状，但与抑郁症状相关的因素尚不清楚。本研究的目的是：(1)研究有抑郁症状和无抑郁症状的照顾者在患者特征和照顾者的功能状态、照顾负担（照顾时间、照顾任务的难度和整体感知照顾痛苦）和感知控制方面的差异；(2)确定照顾者抑郁症状的预测因子。共有109名照护者（平均年龄57岁，配偶照护者79%）和心衰患者参与了这项研究。分别使用贝克抑郁量表ii （BDI-II）、控制态度量表修订版和杜克活动状态指数对患者和护理者的抑郁症状、感知控制和功能状态进行评估。采用Oberst照顾负担量表和Zarit负担访谈法评估照顾者的负担（照顾任务和负担的时间和难度）。27.5%有抑郁症状（BDI-II≥14）的HF照顾者功能状态较差，感知控制能力较低，感知照顾痛苦较高，护理困难较多，护理任务时间较长。在多元回归中控制年龄和性别后，照顾者自身功能障碍（sβ = - 0.307, P < .001）、感知控制（sβ = - 0.304, P < .001）和照顾者负担（sβ =.316, P =. 002）解释了照顾者抑郁症状变异的45%。患者的NYHA等级和功能状态不能预测护理者的抑郁症状。照顾者的功能状态差、照顾痛苦的整体感知和控制感知与抑郁症状相关。心衰患者的抑郁照护者可能受益于改善照护者感知控制、解决照护负担、改善或协助照护者功能状态的干预措施。
Millions of family members deliver informal care and support to patients with heart failure (HF). Caregivers of patients with HF suffer from depressive symptoms, but factors associated with depressive symptoms are unknown. The purposes of this study were (1) to examine differences between caregivers with and without depressive symptoms in patients’ characteristics and caregivers’ functional status, caregiving burden (time devoted to caregiving, difficulty of caregiving tasks, and overall perceived caregiving distress), and perceived control; and (2) to determine predictors of depressive symptoms of caregivers. A total of 109 caregivers (mean age of 57 years; spousal caregiver 79%) and patients with HF participated in this study. Depressive symptoms, perceived control, and functional status of both patients and caregivers were assessed using the Beck Depression Inventory-II (BDI-II), the Control Attitudes Scale-Revised, and the Duke Activity Status Index, respectively. Caregivers’ burden (time and difficulty of caregiving tasks and burden) were assessed using the Oberst Caregiving Burden Scale, and the Zarit Burden Interview. The 27.5% of HF caregivers with depressive symptoms (BDI-II ≥ 14) had poorer functional status, lower perceived control, higher perceived caregiving distress, experienced more caregiving difficulty and spent more time in caregiving tasks than caregivers without depressive symptoms. Controlling for age and gender in a multiple regression, caregivers’ own functional disability (sβ = -.307, P < .001), perceived control (sβ = -.304, P < .001), and caregiver burden (sβ =.316, P = .002) explained 45% of the variance in caregivers’ depressive symptoms. Patients’ NYHA class and functional status did not predict caregivers’ depressive symptoms. Caregivers’ poor functional status, overall perception of caregiving distress, and perceived control were associated with depressive symptoms. Depressed caregivers of patients with HF may benefit from interventions that improve caregivers’ perceived control, address the caregiving burden and improve or assist with caregivers’ functional status.