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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

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128例帕金森病照料者负担及影响因素

刘丽雯1,2,马俊3,李沛铮3,张秀芳3,刘艺鸣3*   

  • 发布日期:2022-04-22
  • 通讯作者: 刘艺鸣. E-mail:liuym@sdu.edu.cn

Caregiver burden and influencing factors of 128 patients with Parkinsons disease

LIU Liwen1,2, MA Jun3, LI Peizheng3, ZHANG Xiufang3, LIU Yiming3   

  1. 1. Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Peoples Hospital of Lixia District of Jinan, Jinan 250014, Shandong, China;
    3. Department of Neurology, Qilu Hospital, Shandong University, Jinan 250012, Shandong, China
  • Published:2022-04-22

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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。

关键词: 帕金森病, 照料者负担, 睡眠片段化, 自我感受负担, 相关性

Abstract: Objective To explore the current situation and influencing factors of caregiver burden of patients with Parkinsons disease so as to reduce caregiver burden. Methods A total of 128 patients with Parkinsons disease treated during Mar. 2017 and Oct. 2019 and their caregivers were enrolled. The general information of patients were assessed with Movement Disorder Society Unified Parkinsons Disease Rating Scale(MDS-UPDRS), Hoehn Yahr Stage, Self-perceived Burden Scale, Parkinsons Disease Sleep Scale(PDSS), Epworth Sleepiness Scale(ESS), Neuropsychiatric Inventory(NPI), Hamilton Anxiety Scale(HAMA), and Hamilton Depression Scale(HAMD). According to the diagnostic criteria of fragmented sleep and statistics of fragmented sleep in PDSS scale, the patients with fragmented sleep were evaluated. The caregiver burden was assessed with Zarit Caregiver Burden Interview(ZBI). The influencing factors were determined with univariate and multivariate Logistic regression analysis. Results There were statistically significant differences in disease course, HY stage, UPDRSIII score, segmented sleep, self-perceived burden, HAMA score, HAMD score, PDSS score, ESS score, NPI score and ZBI score. Self-perceived burden, caregivers neuropsychiatric distress, fragmented sleep, and disease severity(Hoehn-Yahr scale)were independent risk factors of caregiver burden. Conclusion Patients with Parkinsons disease should be diagnosed and treated early, and the sleep quality should be improved on the basis of standardized medication. Paying attention to patients feelings and self-perceived burden can help to reduce the caregiver burden.

Key words: Parkinsons disease, Caregiver burden, Fragmented sleep, Self-perceived burden, Correlation

中图分类号: 

  • R741
[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 Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons disease [J]. Electronic Journal of clinical Medical Literature, 2018, 5(85): 187.
[9] Sveinbjornsdottir S. The clinical symptoms of Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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. Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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 Parkinsons 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.
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