【摘要】 目的:了解居家照顾痴呆患者的配偶的心理和照料负担以及相关因素。方法:在北京城区,按就诊线索收集42例痴呆患者,由经培训的调查员进行入户调查。42例资料齐全,无遗漏。主要调查工具包括对痴呆患者的评定工具:临床分级量表、简明精神状态检查量表(MMSE)、痴呆病人日常生活能力(ADCS-ADL)、阿尔茨海末氏痴呆病理行为问卷(BEHAVE-AD);对照顾者的评定工具:Zung氏焦虑自评量表(SAS)、Zung氏抑郁自评量表(SDS)、照顾者负担问卷(CBI)、痴呆相关知识技能问卷。结果:照顾者的负担重(CBI总分30.7±15.1),他们抑郁情绪(SDS平均分为38.8±8.0,40分以上者42.9%)和焦虑情绪明显(SAS平均分为34.3±8.0,40分以上者23.8%);照顾者对疾病的知识和照顾技能缺乏,有26.2%的照顾者认为痴呆是正常衰老或可治愈的,有57.1%认为患者病情可以好转或能够维持现状。总负担与焦虑(r=0.51,P<0.01)和抑郁(r=0.38,P<0.05)以及患者伴有精神行为异常的严重程度有关(r=0.40,P<0.01);而且照顾者的焦虑情绪与知识技能有关(r=-0.48,P<0.01)。结论:照顾者的心理负担重,焦虑和抑郁情绪明显;照顾者对疾病的知识和照顾技能缺乏;总负担与焦虑和抑郁以及患者伴有精神行为异常的严重程度有关,而且照顾者的焦虑情绪与照顾者的知识技能缺乏有关。更多还原

【Abstract】 Objective: To explore the burden of spouse caregivers of patients with dementia at home and factors having influence.Methods:Forty-two patients with dementia were collected from psychiatric out-clinic consecutively. Trained investigators did home visit to collect data on severity of the disease (CDR, MMSE), pathological behavior (BEHAVE-AD), activity of daily living (ADCS-ADL) and burdens of their spouse as caregiver (CBI). The caregivers’ anxiety, depression (Zung’s Anxiety Scale and Depression Scale) and knowledge about dementia were also collected.Results:The caregivers felt big burden (BDI total score: 30.7±15.1). Nearly half of them (42.9%) were in depression and one quarter (23.8%) were anxious. They were lack of knowledge about dementia and unskillful in care-giving. 26.2% caregivers thought dementia is curable or equal to normal aging, 57.1% of them did not believe it is an improving disease. The burden of caregivers was correlated positively with pathological behavior of patients (r=0.40, P<0.01) and negatively with knowledge and skill (r=-0.48,P<0.01). Caregivers’ feeling of burden were also correlated with anxiety and depression of themselves (r=0.51 and 0.38 respectively, both with P<0.01).Conclusion:The burden of spouse caregivers is great; they are lack of knowledge and skill about caring. The more severe the pathological behavior of the patients, the more burden their spouse felt; the more burden they felt, the more anxious and depressive they are.更多还原