以质量求发展，以服务铸品牌

护理学报 ›› 2025, Vol. 32 ›› Issue (2): 1-6.doi: 10.16460/j.issn1008-9969.2025.02.001

• 研究生园地 •    下一篇

神经外科重症住院患者家庭照顾者照顾负担及影响因素分析

魏利1, 赵兴颖1, 刘佳1, 何雨璇1, 陈晓梅1, 杨雪2, 鲜继淑2, 杨燕妮1   

  1. 1.陆军军医大学（第三军医大学） 护理系,重庆 430008;
    2.陆军军医大学第一附属医院 神经外科,重庆 430008
  • 收稿日期:2024-08-07 出版日期:2025-01-25 发布日期:2025-02-20
  • 通讯作者: 杨燕妮（1970-）,女,湖北宜都人,硕士,硕士研究生导师,教授。E-mail:yangyanni@tmmu.com
  • 作者简介:魏利（1993-）,女,新疆吐鲁番人,本科学历,硕士研究生在读,主管护师。
  • 基金资助:
    国家社会科学基金项目（20BRK039）

Care burden of family caregivers of severe inpatients in neurosurgery department and its influencing factors

WEI Li1, ZHAO Xing-ying1, LIU Jia1, HE Yu-xuan1, CHEN Xiao-mei1, YANG Xue2, XIAN Ji-shu2, YANG Yan-ni1   

  1. 1. Department of Nursing, Army Medical University (Third Military Medical University), Chongqing 400038, China;
    2. Dept. of Neurosurgery, First Affiliated Hospital of Army Medical University, Chongqing 400038, China;
  • Received:2024-08-07 Online:2025-01-25 Published:2025-02-20

PDF (PC)

41

赞

摘要： 目的 了解神经外科重症住院患者家庭照顾者照顾负担水平,并探讨其影响因素。方法 2023年11月—2024年5月采用便利抽样法选取300对神经外科重症住院患者和家庭照顾者,使用一般资料调查表、Zarit 照顾者负担量表、多因素记忆问卷、中文华山版听觉学习测验量表、综合医院焦虑量表,进行调查,采用多元线性回归分析影响因素。结果 神经外科重症住院患者家庭照顾者照顾负担总分为（33.94±17.27）分,70.3%的家庭照顾者存在照顾负担。线性回归分析显示：患者肢体功能障碍、与患者关系、照顾者合并慢性病、焦虑情绪、自评记忆能力和情景记忆是照顾负担的影响因素（P<0.05）。结论 神经外科重症住院患者家庭照顾者照顾负担水平处于中等水平,其影响因素涉及患者及家庭照顾者等多方面,医护人员可通过辅助记忆策略和优化沟通模式等措施降低照顾负担。

关键词: 神经重症, 家庭照顾者, 照顾负担, 影响因素, 神经外科

Abstract: Objective To understand the care burden of family caregivers of severe inpatients in neurosurgery department and to explore its influencing factors. Methods Three hundred pairs of critically ill inpatients and family caregivers in neurosurgery department were selected from November 2023 to May 2024 by convenient sampling, and they were investigated by the General Information Questionnaire, Zarit Burden Interview, Multifactorial Memory Questionnaire, Auditory verbal learning test-huashan version and Hospital Anxiety and Depression Scale. Multiple linear regression was used to analyze its influencing factors. Results The total score of care burden of family caregivers of critically ill inpatients in neurosurgery department was 33.94±17.27, and 70.3% of the family caregivers had care burden. Linear regression analysis showed that patients' limb dysfunction, relationship with the patients, caregivers with comorbid chronic diseases, anxiety, self-rated memory ability and episodic memory were the influencing factors of care burden (P<0.05). Conclusion Care burden of family caregivers for severe inpatients in neurosurgery department is at a moderate level, and it is influenced by various factors related to both the patients and the caregivers. Auxiliary memory strategies and optimized communication patterns should be considered to reduce their care burden.

Key words: neuro critical care, family caregivers, care burden, influencing factor, neurosurgery department

中图分类号: 

  • R473
[1] Moheet AM, Livesay SL, Abdelhak T, et al.Standards for neurologic critical care units: a statement for healthcare professionals from the neurocritical care society[J].Neurocrit Care,2018,29(2):145-160. DOI:10.1007/s12028-018-0601-1.
[2] Venkatasubba Rao CP, Suarez JI, Martin RH, et al.Global survey of outcomes of neurocritical care patients: analysis of the PRINCE Study Part 2[J]. Neurocrit Care,2020,32(1):88-103. DOI:10.1007/s12028-019-00835-z.
[3] Dong X, Chang E, Wong E, et al.A qualitative study of filial piety among community dwelling, chinese, older adults: changing meaning and impact on health and well-being[J]. J Intergenerational Relationships,2012,10(2):131-146. DOI:10.1080/15350770.2012.673393.
[4] Scherbring M.Effect of caregiver perception of preparedness on burden in an oncology population[J]. Oncol Nurs Forum,2002,29(6):E70-E76. DOI:10.1188/02.ONF.E70-E76.
[5] Lonjaret L, Guyonnet M,Berard E,et al.Postoperative complications after craniotomy for brain tumor surgery[J]. Anaesth Crit Care Pain Med,2017,36(4):213-218. DOI:10.1016/j.accpm.2016.06.012.
[6] Au TH,Willis C,Reblin M,et al.Caregiver burden by treatment and clinical characteristics of patients with glioblastoma[J]. Support Care Cancer,2022,30(2):1365-1375. DOI:10.1007/s00520-021-06514-0.
[7] 李貌,秦月兰,苏晚英.脊髓损伤病人家庭照顾者负担研究进展[J].护理研究,2024,38(4):683-686. DOI:10.12102/j.issn.1009-6493.2024.04.022.
[8] Huang N, Tang Y, Zeng P, et al.Psychological status on informal carers for stroke survivors at various phases: a cohort study in China[J]. Front Psychiatry,2023,14:1173062. DOI:10.3389/fpsyt.2023.1173062.
[9] Yu W, Chen J, Sun S, et al.The reciprocal associations between caregiver burden, and mental health in primary caregivers of cancer patients: a longitudinal study: family functioning, caregiver burden, and mental health Wenjun Yu et al[J]. Psychooncology,2021,30(6):892-900. DOI:10.1002/pon.5667.
[10] 中华医学会神经外科学分会, 中国神经外科重症管理协作组.中国神经外科重症管理专家共识(2020版)[J]. 中华医学杂志, 2020,100(19):1443-1458. DOI:10.3760/cma.j.cn112137-20200318-00818.
[11] Bacchetti P, Leung JM.Sample size calculations in clinical research[J]. Anesthesiology,2002,97(4):1028-1029.DOI:10.1097/00000542-200210000-00050.
[12] Teasdale G, Jennett B.Assessment of coma and impaired consciousness. A practical scale[J]. Lancet,1974,2(7872):81-84. DOI:10.1016/s0140-6736(74)91639-0.
[13] Cuthbert SC, Goodheart GJ Jr.On the reliability and validity of manual muscle testing: a literature review[J]. Chiropr Osteopat,2007,15:4. DOI:10.1186/1746-1340-15-4.
[14] Mahoney FI, Barthel DW.Functional evaluation: the barthel index[J]. Md State Med J,1965,14:61-65.
[15] Lu L, Wang L, Yang X, et al.Zarit Caregiver Burden Interview: development, reliability and validity of the Chinese version[J]. Psychiatry Clin Neurosci,2009,63(6):730-734. DOI:10.1111/j.1440-1819.2009.02019.x.
[16] 蒋云云,杨燕妮,黄丽,等.元记忆问卷汉化及应用于社区中老年人的信效度分析[J].护理学杂志,2018,33(8):89-92. DOI:10.3870/j.issn.1001-4152.2018.08.089.
[17] 郭起浩,孙一态,虞培敏,等.听觉词语学习测验的社区老人常模[J]. 中国临床心理学杂志,2007,15(2):132-134. DOI:10.3969/j.issn.1005-3611.2007.02.007.
[18] Snaith RP, Zigmond AS.The hospital anxiety and depression scale[J]. Br Med J (Clin Res Ed),1986,292(6516):344. DOI:10.1136/bmj.292.6516.344.
[19] Hu P, Yang Q, Kong L, et al.Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients[J]. Medicine (Baltimore), 2018,97(40):e12638. DOI:10.1097/MD.0000000000012638.
[20] Bayen E, Laigle-Donadey F, Prouté M, et al.The multidimensional burden of informal caregivers in primary malignant brain tumor[J]. Support Care Cancer,2017,25(1):245-253. DOI:10.1007/s00520-016-3397-6.
[21] Akosile CO, Banjo TO, Okoye EC, et al.Informal caregiving burden and perceived social support in an acute stroke care facility[J]. Health Qual Life Outcomes,2018,16(1):57. DOI:10.1186/s12955-018-0885-z.
[22] Liu J, Bai S, Pan H, et al.Caregiver burden and readiness in patients with moderate and severe traumatic brain injury: the chain mediation effect of disease uncertainty and mental resilience[J]. World Neurosurg, 2024,185:e603-e611. DOI:10.1016/j.wneu.2024.02.084.
[23] Achilike S, Beauchamp J, Cron SG, et al.Caregiver burden and associated factors among informal caregivers of stroke survivors[J]. J Neurosci Nurs,2020,52(6):277-283. DOI:10.1097/JNN.0000000000000552.
[24] 罗佳,郑莉,陈慧平.居家晚癌患者照顾者的照顾负担及其影响因素研究[J].现代预防医学,2023,50(19):3540-3545. DOI:10.20043/j.cnki.MPM.202211521.
[25] Zuo Y, Luo BR, Peng WT, et al.Informal caregiver burden and influencing factors in gynaecological oncology patients hospitalized for chemotherapy: a cross-sectional study[J]. J Int Med Res,2020,48(11):300060520974927. DOI:10.1177/0300060520974927.
[26] Ahmad Zubaidi ZS, Ariffin F, Oun C, et al.Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross sectional study[J]. BMC Palliat Care,2020, 19(1):186. DOI:10.1186/s12904-020-00691-1.
[27] Loh AZ, Tan JS, Zhang MW, et al.The global prevalence of anxiety and depressive symptoms among caregivers of stroke survivors[J]. J Am Med Dir Assoc,2017,18(2):111-116. DOI:10.1016/j.jamda.2016.08.014.
[28] Sherman BE, Huang I, Wijaya EG, et al.Acute stress effects on statistical learning and episodic memory[J].J Cogn Neurosci,2024,36(8):1741-1759.DOI:10.1162/jocn_a_02178.
[29] Gagnon SA, Wagner AD.Acute stress and episodic memory retrieval: neurobiological mechanisms and behavioral consequences[J]. Ann N Y Acad Sci,2016, 1369(1):55-75. DOI:10.1111/nyas.12996.
[30] 张巾英,刘晓,彭滟,等.重庆市社区体检中老年人情景记忆的影响因素研究[J]. 陆军军医大学学报, 2022,44(12):1285-1291. DOI:10.16016/j.2097-0927.202112116.
[31] Corrêa MS, de Lima DB, Giacobbo BL, et al. Mental health in familial caregivers of Alzheimer's disease patients: are the effects of chronic stress on cognition inevitable?[J]. Stress,2019,22(1):83-92.DOI:10.1080/10253890.2018.1510485.
[32] Balash Y, Mordechovich M, Shabtai H, et al.Subjective memory complaints in elders: depression, anxiety, or cognitive decline?[J]. Acta Neurol Scand,2013,127(5):344-350. DOI:10.1111/ane.12038.
[33] Berridge CW,Devilbiss DM, Martin AJ,et al.Stress degrades working memory-related frontostriatal circuit function[J]. Cereb Cortex,2023,33(12):7857-7869. DOI:10.1093/cercor/bhad084.
[34] Lovell B,Elliot H,Liu CC,et al.Memory failures for everyday tasks in caregivers of children with autism[J]. Res Dev Disabil,2014,35(11):3057-3061. DOI:10.1016/j.ridd.2014.07.019.
[35] Kennedy M, Parish AL.Educational theory and cognitive science: practical principles to improve patient education[J]. Nurs Clin North Am,2021, 56(3):401-412. DOI:10.1016/j.cnur.2021.04.006.
[1] 李丹妮, 邱丽燕, 吴隆燕, 谭铮可可, 陈欣, 杨丽. 前交叉韧带损伤日间手术患者恐动症的潜在剖面分析及影响因素研究[J]. 护理学报, 2025, 32(4): 12-17.
[2] 杜易梅, 刘莉, 郭立丽, 卢吉, 付苗苗, 刘杰. 妇科恶性肿瘤患者性健康研究进展[J]. 护理学报, 2025, 32(4): 28-33.
[3] 李长娥, 徐真真, 张文忠, 吴燕, 季红. 新生儿父母脐带血储存决策影响因素的定性研究[J]. 护理学报, 2025, 32(3): 74-78.
[4] 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12.
[5] 刘畅, 张维, 王翠雪, 岳鹏. ICU实施非限制性探视制度的影响因素研究进展[J]. 护理学报, 2025, 32(1): 34-38.
[6] 王进波, 吴姗, 黄蓉蓉, 陈代凤, 洪梅, 李审绥. 头颈癌患者自杀影响因素及干预的研究进展[J]. 护理学报, 2025, 32(1): 39-43.
[7] 陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35.
[8] 曹娟, 李方, 于跃, 戴丽, 杨丹丹, 李志华, 徐欣怡, 戴琪, 陈柯宇. 食管癌术后静脉血栓栓塞症风险预测模型的构建及验证[J]. 护理学报, 2024, 31(8): 63-68.
[9] 朱心悦, 嵇冰聪, 蓝雪芬, 季晓珍. 糖尿病患者电子健康素养研究进展[J]. 护理学报, 2024, 31(7): 36-39.
[10] 李莹, 周志欢. ICU护理缺失的研究进展[J]. 护理学报, 2024, 31(6): 43-46.
[11] 黄鑫, 余丽君, 张二明, 哈丽娜. 稳定期COPD患者的能量摄入现状及影响因素分析[J]. 护理学报, 2024, 31(5): 12-16.
[12] 张思爱, 赖翠薇, 李佳佳, 张亚军, 汪张毅, 张正涛, 法天锷. 护士专业态度的影响因素研究进展[J]. 护理学报, 2024, 31(4): 38-41.
[13] 郑硕, 张卫青, 吴雅萱, 王鑫媛, 法宪恩, 宋洁露, 曹雅冰. 基于Q方法分析痴呆患者家庭照顾者对虚拟护理支持的偏好研究[J]. 护理学报, 2024, 31(3): 1-5.
[14] 林梅燕, 张星星, 李瑞华, 陶思琪, 甄莉. 肠造口患者居家睡眠质量特点及影响因素研究进展[J]. 护理学报, 2024, 31(24): 27-32.
[15] 赵阳, 王岚, 尹雪梅. 正常分娩中非必要干预的研究进展[J]. 护理学报, 2024, 31(24): 33-36.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!