ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
FİZİKSEL TIP VE REHABİLİTASYON
BİLİMLERİ DERGİSİ
www.jpmrs.com
Kayıtlı İndexler


ORIJINAL ARAŞTIRMA

Beyin Hasarlı Hasta Bakımında, Hastaya Yakınlık Derecesinin Bakıcının Anksiyete, Depresyon, Yaşam Kalitesi Düzeyleri ile İlişkisi
Mental Health and Quality of Life Differences Between the Family Members and Paid Caregivers in Brain Injury
Received Date : 09 Apr 2019
Accepted Date : 21 Aug 2019
Available Online : 03 Oct 2019
Doi: 10.31609/jpmrs.2019-66415 - Makale Dili: EN
J PMR Sci. 2019;22(3):85-91
ÖZET
Amaç: Bu çalışmada inme veya travmaya bağlı beyin hasarlı hastaların bakıcılarının fiziksel, psikolojik etkilenimleri ve yaşam kalitesi düzeyleri değerlendirilerek; etkilenim düzeyinde aileden biri olan bakıcılarla ücret karşılığı bakıcılık yapanlar arasındaki fark vurgulanmıştır. Gereç ve Yöntemler: Kesitsel olarak planlanan bu çalışmaya 54 hasta bakıcısı dahil edildi. Bakıcılar, akraba grubu (n=43) ve paralı bakıcılar (n=11) olarak iki gruba ayrıldı. Bakıcı ve hastaların temel karakteristik özellikleri kaydedildi. Tüm bakıcılar Hastane Anksiyete ve Depresyon Ölçeği (HADS) ile Kısa Form-36 (SF-36) anketini doldurdu. Bulgular: Bakım süresi açısından gruplar arasında istatistiksel olarak anlamlı fark vardı. Paralı bakıcı grubunda, hasta yaşı diğer gruptaki hasta yaşından anlamlı olarak daha fazlaydı (p<0,001). Gruplar arasında cinsiyet açısından farklılık saptandı (p=0,001). Etiyoloji, hastalık süresi, afazi varlığı, disfaji, beslenme tipi, üriner inkontinans, işeme tipi, ambulasyon seviyesi açısından gruplar arasında farklılık saptanmadı. HADS anketinin hem anksiyete hem de depresyon puanları, aileden olan bakıcı grubunda anlamlı olarak yüksekti. SF- 36 anketinin sosyal fonksiyon, fiziksel problemler nedeniyle olan kısıtlanma, emosyonel problemler nedeniyle olan kısıtlanma, enerji, vücut ağrısı ve genel sağlık algısı alt parametreleri, aileden olan bakıcı grubunda anlamlı olarak düşüktü. Sonuç: Bu çalışmada, aileden biri olan bakıcılarla ücret karşılığı bakıcılık yapanlar arasındaki fark vurgulanmıştır. Bakıcı aileden birisi ise etkilenim daha fazla olmaktadır ve hastanın özürlülük derecesi ile orantılı şekilde artmaktadır. Rehabilitasyon sürecinin olumsuz etkilenmemesi için, bakıcıların rehabilitasyonun önemli bir parçası olduğu unutulmamalıdır.
ABSTRACT
Objective: In this study, physical, psychological effects and quality of life of caregivers of patients with brain injury due to stroke or trauma were evaluated; and the difference between the family members as caregivers and the paid caregivers were highlighted. Material and Methods: Fifty-four caregivers of patients were included in this cross-sectional study. Caregivers were grouped as relative group (n=43) and self-employed/employed group (n=11). Main characteristics of caregivers and patients were recorded. All caregivers completed Hospital Anxiety and Depression Scale (HADS) and Short Form-36 (SF-36) questionnaires. Results: There was a statistically significant difference between the groups with regard to caregiving duration. In self-employed/ employed group, patients were significantly older than another group (p<0.001). Gender distribution was significantly different between groups (p=0.001). Etiology, disease duration, presence of aphasia, dysphagia, feeding type, urinary incontinence, urination type and ambulation levels were similar in groups. Both anxiety and depression scores of HADS questionnaire were significantly higher in relative group. Social functioning, physical role limitation, emotional role limitation, energy, pain, and general health domains of SF-36 questionnaire were significantly lower in relative group. Conclusion: In this study, the difference between the family members as caregivers and the paid caregivers were highlighted. The affection is more, if the caregiver is a family member, and it increases in proportion to the degree of disability of the patient. It should be noted that the caregivers are an important part of rehabilitation in order not to adversely affect the rehabilitation process.
REFERENCES
  1. Cevikol A, Cakici A. Inme rehabilitasyonu. Oguz H (editor). Tibbi Rehabilitasyon. 3. Baski, Ankara: Nobel Tip Kitabevi, 2015, p.419-48.
  2. Alaca R, Yasar E. Travmatik beyin hasarinda rehabilitasyon. Oguz H (editor). Tibbi Rehabilitasyon. 3. Baski, Ankara: Nobel Tip Kitabevi, 2015, p.419-48. ]
  3. Kratz AL, Sander AM, Brickell TA, et al. Traumatic brain injury caregivers: a qualitative analysis of spouse and parent perspectives on quality of life. Neuropsychol Rehabil. 2017;27:16-37. [Crossref]  [PubMed]  [PMC] 
  4. Em S, Bozkurt M, Caglayan M, et al. Psychological health of caregivers and association with functional status of stroke patients. Top Stroke Rehabil. 2017;24:323-9. [Crossref] 
  5. Hunt D, Smith JA. The personal experience of carers of strok survivors: an interpretative phenomenological analysis. Disabil Rehabil. 2004;26:1000-11. [Crossref]  [PubMed] 
  6. Ware JE, Kosinski M, Keller JL. SF-36 Physical and Mental Health Summary Scales: A User's Manual. 5th ed. Boston, MA: The Health Institute, 1994. p.188.
  7. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-70. [Crossref]  [PubMed] 
  8. Mitchell AJ, Meader N, Symonds P. Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: a meta-analysis. J Affect Disord. 2010;126:335-48. [Crossref]  [PubMed] 
  9. Asiret GD, Kapucu S. Burden of caregivers of stroke patients. Turk J Neurol. 2013;19:5-10. [Crossref] 
  10. Greenwood N, Mackenzie A, Cloud GC, et al. Informal carers of stroke survivors--factors influencing carers: a systematic review of quantitative studies. Disabil Rehabil. 2008;30:1329-49. [Crossref]  [PubMed] 
  11. Gunduz B, Erhan B. Quality of life of stroke patients' spouses living in the community in Turkey: controlled study with short form-36 questionnaire. Journal of Neurological Sciences. 2008;25:226-34.
  12. Visser-Meily A, Post M, Gorter JW, et al. Rehabilitation of stroke patients needs a family-centered approach. Disabil Rehabil. 2006;28:1557-61. [Crossref]  [PubMed] 
  13. Anderson CS, Linton J, Stewart-Wynne EG. A population-based assessment of the impact and burden of caregiving for long-term stroke survivors. Stroke. 1995;26:843-9. [Crossref]  [PubMed] 
  14. Wilz G, Kalytta T. Anxiety symptoms in spouses of stroke patients. Cerebrovasc Dis. 2008;25:311-5. [Crossref]  [PubMed] 
  15. Hung JW, Huang YC, Chen JH, et al. Factors associated with strain in informal caregivers of stroke patients. Chang Gung Med J. 2012;35:392-401. [Crossref] 
  16. Jaracz K, Grabowska-Fudala B, Kozubski W. Caregiver burden after stroke: towards a structural model. Neurol Neurochir Pol. 2012;46:224-32. [Crossref]  [PubMed] 
  17. Forsberg-Warleby G, Muller A, Blomstrand C. Spouses of first-ever stroke patients: psychological well-beinig in the first phase after stroke. Stroke. 2001;32:1646-51. [Crossref]  [PubMed] 
  18. Van Puymbroeck M, Rittman MR. Quality-of-life predictors for caregivers at 1 and 6 months poststroke: results of path analyses. J Rehabil Res Dev. 2005;42:747-60. [Crossref]  [PubMed] 
  19. Ostwald SK, Bernal MP, Cron SG, et al. Stress experienced by stroke survivors and spousal caregivers during the first year after discharge from inpatient rehabilitation. Top Stroke Rehabil. 2009;16:93-104. [Crossref]  [PubMed]  [PMC] 
  20. Dennis M, O'Rourke S, Lewis S, et al. A quantitative study of the emotional outcome of people caring for stroke survivors. Stroke. 1998;29:1867-72. [Crossref]  [PubMed] 
  21. Cameron JI, Cheung AM, Streiner DL, et al. Stroke survivor depressive symptoms are associated with family caregiver depression during the first 2 years poststroke. Stroke. 2011;42:302-6. [Crossref]  [PubMed] 
  22. Clay OJ, Grant JS, Wadley VG, et al. Correlates of health-related quality of life in African American and Caucasian stroke caregivers. Rehabil Psychol. 2013;58:28-35. [Crossref]  [PubMed]  [PMC] 
  23. Morimoto T, Schreiner AS, Asano H. Caregiver burden and healthrelated quality of life among Japanese stroke caregivers. Age Ageing. 2003;32:218-23. [Crossref]  [PubMed] 
  24. Roth DL, Perkins M, Wadley VG, et al. Family caregiving and emotional strain: associations with quality of life in a large national sample of middle-aged and older adults. Qual Life Res. 2009;18:679-88. [Crossref]  [PubMed]  [PMC] 
  25. McCullagh E, Brigstocke G, Donaldson N, et al. Determinants of caregiving burden and quality of life in caregivers of stroke patients. Stroke. 2005;36:2181-6. [Crossref]  [PubMed]