128例帕金森病照料者负担及影响因素  

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

作　　者：刘丽雯 马俊[3] 李沛铮 张秀芳[3] 刘艺鸣[3] LIU Liwen;MA Jun;LI Peizheng;ZHANG Xiufang;LIU Yiming(Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;People's Hospital of Lixia District of Jinan,Jinan 250014,Shandong,China;Department of Neurology,Qilu Hospital,Shandong University,Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医学院,山东济南250012 [2]济南市历下区人民医院,山东济南250014 [3]山东大学齐鲁医院神经内科,山东济南250012

出　　处：《山东大学学报（医学版）》2022年第4期45-49,共5页Journal of Shandong University:Health Sciences

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。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.

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 

分 类 号：R742.5[医药卫生—神经病学与精神病学]