老年髋部骨折患者照顾者照顾负荷及影响因素的纵向研究

A longitudinal study on the influencing factors and the burden on primary caregivers of elderly hip fracture patients

目的 调查老年髋部骨折患者照顾者的负荷水平,并探讨与负荷相关的影响因素,分析动态变化,为相关干预性研究提供依据.方法 本研究采用描述性研究方法,对2014年5月-2016年5月在骨科接受住院治疗的老年髋部骨折患者及主要家庭照顾者各212例进行随访调查,调查时间点为出院前、出院后1个月、出院后3个月.调查工具包括老年髋部骨折患者及照顾者一般情况调查表、照顾者负荷问卷、照顾者照顾能力问卷.结果 主要照顾者照顾能力处于中等水平.主要照顾者在院期间和离院后都承受着中等程度的负荷,其中以患者出院后1个月的照顾负荷最重.广义估计方程显示,无论是出院前还是出院后,髋部骨折患者的ADL评分、照顾者性格及其月收入是影响老年髋部骨折患者照顾者的主要影响因素.结论 护理人员在临床工作中应该充分关注老年髋部骨折患者主要照顾者的照顾负荷及其影响因素,通过对患者及其主要照顾者进行综合评估,给予针对性的护理服务和出院后指导,达到提高照顾者的照顾能力、减轻其照顾负荷、提高老年髋部骨折患者及照顾者生活质量的目的.

ObjectiveTo investigate the dynamic changes of the burden on primary caregivers of elderly hip fracture patients, and to analyze the influencing factors, so as to provide reference.Methods This study used descriptive research method.Collected in May 2014 to May 2016 Orthopedic Department, the elderly patients treated with hip fracture and their primary family caregivers of 212 cases for visit investigation before discharge, and the time points were the time before discharge, 1 month after discharge, 3 months after discharge. Survey tools included elderly hip fracture patients and caregivers general situation questionnaire, CaregiverBurdenInventory （CBI）, and Caregivers＆#39; Competencies Questionnaire（CCQ）.Results The main caregivers＆#39; competencies were in the medium level. Primary caregivers in hospital and after discharge were under moderate load, in which patients discharged from hospital after 1 month with the heaviest load.The results of GEE indicated that whether before or after discharge from the hospital, ADL scores in elderly patients with hip fracture, caregivers character and their monthly income were the main factors for the caregivers. Conclusions Nursing staff should pay close attention to and assess the burden and the competencies ofthe caregivers of patients, and provide continuous individualized nursing services in hospital and after discharge, and thereby to promote the caregivers＆#39; competencies, relieve their burden and promote the recovery of patients.