山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (4): 45-49.doi: 10.6040/j.issn.1671-7554.0.2021.1250
• • 上一篇
刘丽雯1,2,马俊3,李沛铮3,张秀芳3,刘艺鸣3*
LIU Liwen1,2, MA Jun3, LI Peizheng3, ZHANG Xiufang3, LIU Yiming3
摘要: 目的 了解帕金森病患者照料者负担的现状,初步分析帕金森病照料者负担的影响因素,以采取措施减轻照料者负担。 方法 纳入2017年3月至2019年10月于山东大学齐鲁医院神经内科门诊就诊的128例原发性帕金森病患者及其主要照料者。收集患者的一般资料,评估量表包括国际运动障碍协会统一帕金森病评定量表评分(MDS-UPDRS)、Hoehn-Yahr分级、自我感受负担量表评分、帕金森病睡眠量表(PDSS)、Epworth嗜睡量表(ESS)、神经精神科问卷评估(NPI)、汉密尔顿焦虑量表(HAMA )、汉密尔顿抑郁量表(HAMD);根据片段化睡眠的诊断标准及PDSS量表中是否有片段睡眠的统计,评估存在片段化睡眠的患者。应用Zarit 护理负担量表(ZBI)进行照料者负担评估。将上述变量逐一与Zarit照顾负担得分进行单因素分析,得出有意义的因素纳入多因素分析,采用多元线性回归研究照料者负担的相关影响因素。 结果 患者病程、HY分期、国际帕金森病与运动障碍协会(MDS)改良的统一帕金森病评价量表第Ⅲ部分(UPDRSⅢ)、是否有片段化睡眠、自我感受负担、HAMA评分、HAMD评分、PDSS评分、ESS评分、NPI评分与 ZBI得分差异均有统计学意义。自我感受负担、照料者神经精神苦恼程度、片段化睡眠、疾病严重程度(Hoehn-Yahr分级)是照料者负担的独立危险因素。 结论 帕金森病患者应早诊断,早治疗,在规范用药的基础上提高睡眠质量,关注患者的自我负担感受及情绪有利于减轻照顾者负担。
中图分类号:
[1] 赵文婷,伊新艳,张璇. 影响帕金森病运动亚型的相关因素分析[J]. 中风与神经疾病杂志, 2020, 5: 419-423. ZHAO Wenting, YI Xinyan, ZHANG Xuan. Parkinsonism in Parkinsons disease [J]. J Stroke Neuro Dis, 2020, 5: 419-423. [2] Grün D, Pieri V, Vaillant M, et al. Contributory factors to caregiver burden in Parkinson disease [J]. J Am Med Rec Assoc, 2016, 17(7): 626-632. [3] Baik JS, Kim JS, Koh SB, et al. Patients and their caregivers burdens for Parkinsons disease in Korea [J]. Mov Disord, 2017, 10(3): 109. [4] Mosley PE, Moodie R, Dissanayaka N. Caregiver burden in Parkinson disease: a critical review of recent literature [J]. J Geriatr Psychiatry Neurol, 2017, 30(5): 235-252. [5] Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinsons disease [J]. Mov Disord, 2015, 30(12): 1591-1601. [6] 杜夏. 帕金森病患者睡眠获益现象的临床特征及其相关因素分析[D]. 济南: 山东大学, 2018. [7] Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study [J]. Gerontologist, 1986, 26(3): 260-266. [8] 薛哓莉, 许景亮, 王开军, 等. 帕金森病患者生活质量影响因素调查分析[J]. 临床医药文献电子杂志, 2018, 5(85): 187. XUE Xiaoli, XU Jingliang, WANG Kaijun, et al. Analysis of factors influencing quality of life in patients with Parkinsons disease [J]. Electronic Journal of clinical Medical Literature, 2018, 5(85): 187. [9] Sveinbjornsdottir S. The clinical symptoms of Parkinsons disease [J]. J Neurochem, 2016, 139: 318-324. doi: 10.1111/jnc.13691. [10] Rajiah K, Maharajan MK, Yeen SJ, et al. Quality of life and caregivers burden of Parkinsons disease [J]. Neuroepidemiology, 2017, 48(3-4): 131-137. [11] Tarolli CG, Zimmerman GA, Auinger P, et al. Symptom burden among individuals with Parkinson disease: a national survey[J]. Neurol Clin Pract, 2020, 10(1): 65-72. [12] Karlstedt M, Fereshtehnejad SM, Aarsland D, et al. Mediating effect of mutuality on caregiver burden in Parkinsons disease partners [J]. Aging Ment Health, 2020, 24(9): 1421-1428. [13] Greenwell K, Gray K, Van Wersch A, et al. Predictors of the psychosocial impact of being a carer of people living with Parkinsons disease: a systematic review [J]. Parkinsonism Relat Disord, 2015, 21(1): 1-11. [14] Sutter M, Perrin PB, Chang YP, et al. Linking family dynamics and the mental health of Colombian dementia caregivers [J]. Am J Alzheimers Dis Other Demen, 2014, 29(1): 67-75. [15] Shin H, Youn J, Kim JS, et al. Caregiver burden in Parkinson disease with dementia compared to Alzheimer disease in Korea [J]. J Geriatr Psychiatry Neurol, 2012, 25(4): 222-226. [16] 吴伟博, 卢惠娴. 帕金森病伴发精神障碍特点及其生活质量的影响[J]. 齐齐哈尔医学院学报, 2014, 35(3): 331-333. WU Weibo, LU Huixian. Parkinsons disease: a review [J]. Journal of Qiqihar Medical University, 2014, 35(3): 331-333. [17] Shin H, Lee JY, Youn J, et al. Factors contributing to spousal and offspring caregiver burden in Parkinsons disease [J]. Eur Neurol, 2012, 67(5): 292-296. [18] Santos-García D, de la Fuente-Fernández R. Impact of non-motor symptoms on health-related and perceived quality of life in Parkinsons disease [J]. J Neurol Sci, 2013, 332(1-2): 136-140. [19] 何荆贵, 王鲁宁, 张熙, 等. 93 例帕金森病患者睡眠障碍的临床特征分析[J]. 中华老年医学杂志, 2005, 24(11): 831-834. HE Jinggui, WANG Luning, ZHANG Xi, et al. Clinical characteristics of sleep disorder in 93 patients with Parkinsons disease [J]. Chinese journal of geriatric medicine, 2005, 24(11): 831-834. [20] Bartolomei L, Pastore A, Meligrana L, et al. Relevance of sleep quality on caregiver burden in Parkinsons disease [J]. Neurol Sci, 2018, 39(5): 835-839. [21] Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ. Quality of life and burden in caregivers for patients with Parkinsons disease: concepts, assessment and related factors [J]. Expert Rev Pharmacoecon Outcomes Res, 2012, 12(2): 221-230. [22] Boland DF, Stacy M. The economic and quality of life burden associated with Parkinsons disease: a focus on symptoms [J]. Am J Manag Care, 2012, 18(7 Suppl): S168- S175. [23] Harder S. Attachment in Schizophrenia-implications for research, prevention, and treatment [J]. Schizophr Bull, 2014, 40(6): 1189-1193. [24] Macchi ZA, Koljack CE, Miyasaki JM, et al. Patient and caregiver characteristics associated with caregiver burden in Parkinsons disease: a palliative care approach [J]. Ann Palliat Med, 2020, 9(Suppl 1): S24-S33. [25] 陈庆菊, 吴倩, 岑模芬, 等. 高职院校学生心理安全感与人际信任的关系研究[J]. 重庆电力高等专科学校学报, 2019, 24(1): 50-56. CHEN Qingju, WU Qian, CEN Mofen, et al. Research on the relationship between psychological security and interpersonal trust of vocational college students [J]. Journal of Chongqing Electric Power College, 2019, 24(1): 50-56. |
[1] | 赵海龙,王皓,方雨晴,毛飞,赵张宁,田祥奇,徐新荣,王敏,李秀华. 增服艾地苯醌对34例帕金森病抑郁患者的疗效观察[J]. 山东大学学报 (医学版), 2022, 60(4): 38-44. |
[2] | 王静,刘粉,曾荣,黄思源,许长娟,梁子婷,董亮. 以胸膜病变为特征的IgG4相关性肺疾病1例[J]. 山东大学学报 (医学版), 2022, 60(3): 114-116. |
[3] | 高金梅,张向莲,刘铁菊. 血浆D-二聚体与109例膀胱癌中发生31例转移的关联性分析[J]. 山东大学学报 (医学版), 2021, 59(3): 98-102. |
[4] | 李湘青,殷欣,赵雪莲,赵培庆. NK细胞亚群CD56bright在帕金森患者外周血中的表达及临床意义[J]. 山东大学学报 (医学版), 2021, 59(2): 34-40. |
[5] | 张嘉豪,刘东旭. 70例不同垂直骨面型骨性Ⅱ类错牙合磨牙及基骨横向特征[J]. 山东大学学报 (医学版), 2021, 59(2): 76-82. |
[6] | 勾云, 周波, 魏操,陈运华, 徐利,刘芬, 张春林, 文敏. 硫辛酸对帕金森病大鼠黑质线粒体的保护作用[J]. 山东大学学报(医学版), 2017, 55(8): 18-23. |
[7] | 崔萌,郑冀鲁,田思男,李连军,张琦,金讯波,王慕文. 前列腺绿激光汽化术治疗良性前列腺梗阻伴帕金森病的疗效[J]. 山东大学学报(医学版), 2017, 55(7): 100-102. |
[8] | 蒋洁,张晓黎,董明,刘金波,蒋玲. 肿瘤相关性骨软化症3例分析并文献复习[J]. 山东大学学报(医学版), 2017, 55(5): 108-111. |
[9] | 张文君,沈遥遥,戴庭敏,柴艺轩,涂江龙. 帕金森病并发喉痉挛1例[J]. 山东大学学报(医学版), 2017, 55(5): 125-126. |
[10] | 马翔宇,李卫国,陈思,陈腾,李超,徐硕,徐淑军,李新钢. 山东大学齐鲁医院神经外科脑深部电刺激术手术步骤标准化操作流程(SOP)暨核查表[J]. 山东大学学报(医学版), 2017, 55(5): 117-121. |
[11] | 孟伟,吴大玮,单悌超,张帆,郭海鹏,刘宇,丁士芳,翟茜. 替加环素治疗重症患者呼吸机相关性肺炎[J]. 山东大学学报(医学版), 2017, 55(4): 71-75. |
[12] | 吴倩,倪阳,杨清锐,孙红胜. 双眼睑肿胀及双侧颌下包块1例——IgG4相关性疾病的诊断与思考[J]. 山东大学学报(医学版), 2017, 55(11): 93-96. |
[13] | 王思,李秀华,杜鹃,岳龙涛,王瑶,刘菲,郭配. 侧脑室注射腺病毒介导的GDNF基因对帕金森病的保护作用[J]. 山东大学学报(医学版), 2016, 54(4): 32-36. |
[14] | 杨璐, 周英泽, 倪明, 樊秀双, 满建梅, 郭军堂. β-synuclein对Ⅱ型囊泡单胺转移体表达的促进作用[J]. 山东大学学报(医学版), 2015, 53(4): 61-64. |
[15] | 陈思, 王牧川, 任楠楠, 许巍, 王玲玲, 栾海辉, 马俊, 刘艺鸣. Parkin基因多态性与山东省汉族帕金森病发病风险的关系[J]. 山东大学学报(医学版), 2015, 53(4): 71-74. |
|