{"title":"慢性危重病人气管造口的家庭护理:照顾者负担的研究及与印度姑息治疗病人负担的比较","authors":"Upendra Hansda, Swagata Tripathy, Alok Kumar Sahoo, Itimayee Panda, Asha P Shetty, Jayanta Kumar Mitra, Kasturi Sanyal, Mahalingam Venkateshan, Nanda Kumar Paniyadi, Parnandi Bhaskar Rao, Sujata Mahapatra","doi":"10.5005/jp-journals-10071-24151","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Chronically critically ill (CCI) patients often have high costs of care and poor outcomes. Disease management programs offering home care may reduce costs but need buy-in from informal caregivers. An understanding of caregiver burden in this population is lacking. We aimed to study the caregiver burden, its change over time, and factors affecting it, in post-ICU tracheostomized patients. We compared the caregiver burden among CCI carers to that of palliative caregivers.</p><p><strong>Materials and methods: </strong>Informal caregivers of thirty chronically critically ill tracheostomized patients (CGcci) were administered the Caregivers Burden Scale (CBS) tool at discharge, 2 and 4 weeks after discharge. A one-point assessment of burden was made in 30 caregivers of patients enrolled in Pain and Palliative care clinic (CGpc). Linear mixed models for repeated measures were used to analyze score of CGcci over time and compared to the burden in physical, psychologic, economic, time, and social domains between groups.</p><p><strong>Results: </strong>All 60 caregivers were young (33-35 years), predominantly male, and children of the patients. Both CGcci and CGpc had moderate burden score of 60.5 (14.7) vs 61.5 (13), respectively. Physical burden (11.5 vs 8) was greater in CGcci (<i>p</i> = 0.001) compared to psychologic domain (10 vs 12.5) in CGpc (<i>p</i> = 0.01). Burden score over all domains in CGcci decreased rapidly from 67.5 (8) to 55 (16.5) (<i>p</i> = 0.001) in the first month after discharge.</p><p><strong>Conclusion: </strong>Burden of care among caregivers of tracheostomized chronically critically ill patients is comparable to those of palliative caregivers and reduces significantly with time.</p><p><strong>Ctri: </strong>2020/11/029443 (registered on: 27/11/2020).</p><p><strong>How to cite this article: </strong>Hansda U, Tripathy S, Sahoo AK, Panda I, Shetty AP, Mitra JK, <i>et al</i>. Home Care of Tracheostomized Chronically Critically Ill Patients: A Study of Caregivers' Burden and Comparison with the Burden of Palliative Care Patients in India. Indian J Crit Care Med 2022;26(5):579-583.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"579-583"},"PeriodicalIF":1.5000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/ca/ijccm-26-579.PMC9160625.pdf","citationCount":"1","resultStr":"{\"title\":\"Home Care of Tracheostomized Chronically Critically Ill Patients: A Study of Caregivers' Burden and Comparison with the Burden of Palliative Care Patients in India.\",\"authors\":\"Upendra Hansda, Swagata Tripathy, Alok Kumar Sahoo, Itimayee Panda, Asha P Shetty, Jayanta Kumar Mitra, Kasturi Sanyal, Mahalingam Venkateshan, Nanda Kumar Paniyadi, Parnandi Bhaskar Rao, Sujata Mahapatra\",\"doi\":\"10.5005/jp-journals-10071-24151\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Chronically critically ill (CCI) patients often have high costs of care and poor outcomes. Disease management programs offering home care may reduce costs but need buy-in from informal caregivers. An understanding of caregiver burden in this population is lacking. We aimed to study the caregiver burden, its change over time, and factors affecting it, in post-ICU tracheostomized patients. We compared the caregiver burden among CCI carers to that of palliative caregivers.</p><p><strong>Materials and methods: </strong>Informal caregivers of thirty chronically critically ill tracheostomized patients (CGcci) were administered the Caregivers Burden Scale (CBS) tool at discharge, 2 and 4 weeks after discharge. A one-point assessment of burden was made in 30 caregivers of patients enrolled in Pain and Palliative care clinic (CGpc). Linear mixed models for repeated measures were used to analyze score of CGcci over time and compared to the burden in physical, psychologic, economic, time, and social domains between groups.</p><p><strong>Results: </strong>All 60 caregivers were young (33-35 years), predominantly male, and children of the patients. Both CGcci and CGpc had moderate burden score of 60.5 (14.7) vs 61.5 (13), respectively. Physical burden (11.5 vs 8) was greater in CGcci (<i>p</i> = 0.001) compared to psychologic domain (10 vs 12.5) in CGpc (<i>p</i> = 0.01). Burden score over all domains in CGcci decreased rapidly from 67.5 (8) to 55 (16.5) (<i>p</i> = 0.001) in the first month after discharge.</p><p><strong>Conclusion: </strong>Burden of care among caregivers of tracheostomized chronically critically ill patients is comparable to those of palliative caregivers and reduces significantly with time.</p><p><strong>Ctri: </strong>2020/11/029443 (registered on: 27/11/2020).</p><p><strong>How to cite this article: </strong>Hansda U, Tripathy S, Sahoo AK, Panda I, Shetty AP, Mitra JK, <i>et al</i>. Home Care of Tracheostomized Chronically Critically Ill Patients: A Study of Caregivers' Burden and Comparison with the Burden of Palliative Care Patients in India. 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引用次数: 1
摘要
慢性危重症(CCI)患者往往有高成本的护理和不良的结果。提供家庭护理的疾病管理项目可能会降低成本，但需要非正式护理人员的支持。对这一人群的照顾者负担缺乏了解。我们的目的是研究icu气管造口术后患者的护理人员负担，其随时间的变化及其影响因素。我们比较了CCI照护者与姑息照护者的照护负担。材料与方法:对30例慢性危重气管造口患者(CGcci)的非正式护理人员在出院、出院后2周和出院后4周进行护理人员负担量表(CBS)评估。对30名在疼痛和姑息治疗诊所(CGpc)登记的患者的护理人员进行了一分负担评估。使用重复测量的线性混合模型分析CGcci随时间的得分，并比较各组间在生理、心理、经济、时间和社会领域的负担。结果:60名护理人员均为年轻(33-35岁)，以男性为主，且均为患者的子女。CGcci和CGpc均为中度负担评分，分别为60.5分(14.7分)和61.5分(13分)。CGcci患者的身体负担(11.5比8)(p = 0.001)大于CGpc患者的心理负担(10比12.5)(p = 0.01)。出院后第一个月CGcci各领域负担评分从67.5(8)迅速下降到55 (16.5)(p = 0.001)。结论:慢性危重病人气管造口护理人员的护理负担与姑息治疗护理人员相当，且随时间延长而显著减轻。ctrl: 2020/11/029443(注册日期:27/11/2020)。如何引用本文:Hansda U, Tripathy S, Sahoo AK, Panda I, Shetty AP, Mitra JK等。慢性危重病人气管造口的家庭护理:照顾者负担的研究及与印度姑息治疗病人负担的比较中华检验医学杂志;2009;26(5):579-583。
Home Care of Tracheostomized Chronically Critically Ill Patients: A Study of Caregivers' Burden and Comparison with the Burden of Palliative Care Patients in India.
Introduction: Chronically critically ill (CCI) patients often have high costs of care and poor outcomes. Disease management programs offering home care may reduce costs but need buy-in from informal caregivers. An understanding of caregiver burden in this population is lacking. We aimed to study the caregiver burden, its change over time, and factors affecting it, in post-ICU tracheostomized patients. We compared the caregiver burden among CCI carers to that of palliative caregivers.
Materials and methods: Informal caregivers of thirty chronically critically ill tracheostomized patients (CGcci) were administered the Caregivers Burden Scale (CBS) tool at discharge, 2 and 4 weeks after discharge. A one-point assessment of burden was made in 30 caregivers of patients enrolled in Pain and Palliative care clinic (CGpc). Linear mixed models for repeated measures were used to analyze score of CGcci over time and compared to the burden in physical, psychologic, economic, time, and social domains between groups.
Results: All 60 caregivers were young (33-35 years), predominantly male, and children of the patients. Both CGcci and CGpc had moderate burden score of 60.5 (14.7) vs 61.5 (13), respectively. Physical burden (11.5 vs 8) was greater in CGcci (p = 0.001) compared to psychologic domain (10 vs 12.5) in CGpc (p = 0.01). Burden score over all domains in CGcci decreased rapidly from 67.5 (8) to 55 (16.5) (p = 0.001) in the first month after discharge.
Conclusion: Burden of care among caregivers of tracheostomized chronically critically ill patients is comparable to those of palliative caregivers and reduces significantly with time.
Ctri: 2020/11/029443 (registered on: 27/11/2020).
How to cite this article: Hansda U, Tripathy S, Sahoo AK, Panda I, Shetty AP, Mitra JK, et al. Home Care of Tracheostomized Chronically Critically Ill Patients: A Study of Caregivers' Burden and Comparison with the Burden of Palliative Care Patients in India. Indian J Crit Care Med 2022;26(5):579-583.
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