치매 환자 간병인의 부담

Abstract

Objectives : The caregiver burden means emotional, social, financial, psyc-hological physical problems which could be experienced occupational caregivers or families who cared disable patients. The caregiver burden affected by primary stressors (severity of disa-bility in dementia patients) and secondary stressors (withdrawal from society, conflict between job and caregiving, loss of personal identify) may result in physical ill-health, depression, anxiety for the caregiving. The aims of this study were to assess caregiver burden in dementia, and to identify affecting factors. Methods : 30 caregivers for dementia patients who had been treated at the "Dementia-Geriatric Mental Health Clinic" in the Kosin University Gospel Hospital and 44 healthy volunteers were sel-edcted. Using the screen for CaregIver Burden (SCB), the degree of caregiver burden was measu-red. The demographic data was obtained by structured interview. Primary and secondary stressors were also analyzed. The severity of depression and anxiety was assessed by the Hamilton Depre-ssion Scale (HDS) and Hamilton Anxiety Scale (HAS). The severity of cognitive dysfunction (MMSE, CDR, GDS), behavioral symptoms (Revised Memory and Behavior Problems Checklist, PMBPC), daily functional disability (ADL, IADL) for the dementia patients were evaluated. Results : 1) The SCB scores were significantly (p<0.001) higher in dementia caregivers (8.71±4.90) than in controls (0.23±0.48).2) The SCB scores were not correlated with age of care-givers (γ=0.081), education (γ=-0.613), duration of caregiving (γ=0.275). The RMBPC scores had statistically significant positive correlation with SCB scores (γ=0.545, p<0.01), while age if dementia patients (γ=-0.234), onset age of dementia (γ=-0.280), duration of dementia (γ=0.029), CDR (γ=0.080), GDS (γ=-0.125), MMSE (γ=-0.212), ADL (γ=-0.315), IADL (γ=0.155) had not. 3) The SCB scores had statistically significant po-sitive correlation with degree of secondary stress (γ=0.581, p<0.01) and anxiety (γ=0.376, p<0.05). The degree of secondary stress had statistically significant positive correlation with degree of emotional stress (γ=0.757, p<0.01), depression (γ=0.482, p<0.01), anxiety (γ=0.376, p<0.01). Conclusion : The caregiver burden in dementia seemed to be originated from primary stressors related to the behavioral symptoms as well as secondary stressors (degree of emotional stress, depression, anxiety, etc.). Therefore, active intervention by the geriatric specialists might be helpful to reduce their strain.